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Published on: September 22, 2014
Problems solved and lives saved? Chronic heart failure
1Department of Cardiology, Western General Hospital, Edinburgh.
Insights
Angiotensin-converting enzyme (ACE) inhibitors significantly reduce mortality and morbidity in chronic heart failure (CHF). This review provides guidelines for using ACE inhibitors and discusses digoxin
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic heart failure (CHF) is a prevalent and serious condition.
- Left ventricular dysfunction can precede overt CHF symptoms.
Purpose of the Study:
- To review the benefits of ACE inhibitors in CHF.
- To provide guidelines for ACE inhibitor use in various settings.
- To consider new evidence on digoxin and management of co-existing conditions.
Main Methods:
- Review of recent studies on ACE inhibitors.
- Consideration of new evidence regarding digoxin.
- Discussion of managing angina and arrhythmias in CHF patients.
Main Results:
- ACE inhibitors reduce morbidity and mortality across all CHF grades.
- ACE inhibitors may delay or prevent CHF in asymptomatic left ventricular dysfunction.
- New evidence on digoxin benefits is presented.
Conclusions:
- ACE inhibitors are crucial for managing CHF.
- Guidelines for ACE inhibitor use in hospital and general practice are provided.
- Comprehensive management of CHF includes addressing concomitant conditions.
Abstract:
Chronic heart failure (CHF) is common, disabling and deadly. Recent studies show that ACE inhibitors reduce morbidity and mortality in all grades of CHF and may even delay or prevent the onset of overt CHF in patients with asymptomatic left ventricular dysfunction. In this review, guidelines are given for how to use these drugs both in hospital and in general practice. New evidence on the benefits of digoxin is also considered, and the management of concomitant problems such as angina and arrhythmias in patients with CHF is discussed.
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