An overview of integration of therapy for congestive heart failure

Patients with symptoms of congestive heart failure look to treatment to relieve symptoms, improve the quality of life, and prolong life. They prefer a convenient dosing schedule, with minimal side effects and low cost. A wide variety of agents are available to treat patients with congestive heart failure. The three major classes of drugs that improve heart failure include the diuretics, inotropic drugs, and vasodilators. It appears that any one of these three classes are potential first-line candidates for treating patients with congestive heart failure. Patients with edema usually require long-term therapy with diuretic agents. Since the vasodilators are the only class of drugs which have been shown to prolong life, they should be used routinely in the management of patients with congestive heart failure. Since all three classes of drugs have additive beneficial hemodynamic effects, it makes sense to consider the use of all three in patients with at least moderate to severe heart failure. At the moment unanswered questions include the role of antiarrhythmic agents in reducing the incidence of sudden death, and the use of potent new inotropic vasodilators. Overall, the current therapeutic approach to patients with heart failure is effective in relieving symptoms, improving exercise tolerance and in prolonging life.