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arb vs ace inhibitor in heart failure

Ki Hong Choi, Ga Yeon Lee, Jin-Oh Choi, Eun-Seok Jeon, Hae-Young Lee, Hyun-Jai Cho, Sang Eun Lee, Min-Seok Kim, Jae-Joong Kim, Kyung-Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok-Min Kang, Dong-Ju Choi, Byung-Su Yoo, Kye Hun Kim, Hyun-Young Park, Myeong-Chan Cho, Byung-Hee Oh
BACKGROUND: After introduction of up-titration strategy, there are limited data on comparison between the effects of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocker (ARB) in patients with heart failure with reduced ejection fraction (HFrEF). The study sought to investigate the association between treatment with ARB at discharge and clinical outcomes in patients with HFrEF compared with treatment with ACEI or no renin angiotensin system blocker (RASB). METHODS: The KorAHF registry is a prospective multicenter cohort and included patients who were hospitalized for acute heart failure (AHF)...
April 15, 2018: International Journal of Cardiology
Tetsuo Yamaguchi, Takeshi Kitai, Takamichi Miyamoto, Nobuyuki Kagiyama, Takahiro Okumura, Keisuke Kida, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Junji Yamaguchi, Takamasa Iwai, Sadahiro Hijikata, Ryo Masuda, Ryoichi Miyazaki, Nobuhiro Hara, Yasutoshi Nagata, Toshihiro Nozato, Yuya Matsue
Guideline-directed medical therapy (GDMT) is recommended for patients with heart failure with reduced ejection fraction (HFrEF). However, the prognostic impact of medication optimization at the time of discharge in patients hospitalized with heart failure (HF) is unclear. We analyzed 534 patients (73 ± 13 years old) with HFrEF. The status of GDMT at the time of discharge (prescription of angiotensin converting enzyme inhibitor [ACE-I]/angiotensin receptor blocker [ARB] and β blocker [BB]) and its association with 1-year all-cause mortality and HF readmission were investigated...
February 21, 2018: American Journal of Cardiology
Chen-Yu Huang, Yao-Hsu Yang, Lian-Yu Lin, Chia-Ti Tsai, Juey-Jen Hwang, Pau-Chung Chen, Jiunn-Lee Lin
OBJECTIVES: Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) is associated with increased mortality, mainly mediated by increased thromboembolic events and progressive heart failure. Many studies suggested inhibition of renin-angiotensin-aldosterone system (RAAS) could reduce new AF in various clinical conditions. However, evidence concerning the effects of RAAS inhibitors on AF prevention remains unclear in HCM. Our study is to investigate whether treatment with ACE inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) could lower the risk of new AF in HCM...
January 25, 2018: Heart: Official Journal of the British Cardiac Society
Martin H Strauss, Alistair S Hall
The renin angiotensin aldosterone system (RAAS) plays a central role in the pathophysiology of hypertension and vascular disease. Angiotensin-converting enzyme inhibitors (ACEi's) suppress angiotensin II (ANG II) concentrations, whereas angiotensin II type 1 (AT1) receptor blockers (ARBs) block the binding of ANG II to AT1 receptors. ACEi's and ARBs are both effective antihypertensive agents and produce similar risk reductions for stroke, a blood pressure-dependent phenomenon. ACEi's also reduce the risk for myocardial infarction (MI) and all-cause mortality in high-risk hypertensive patients as well as in people with diabetes, vascular disease and congestive heart failure...
December 22, 2017: Canadian Journal of Diabetes
Masanori Suzuki, Yuya Matsue, Sayaka Izumi, Ayako Kimura, Tomoaki Hashimoto, Kentaro Otomo, Hiroshi Saito, Makoto Suzuki, Yasuhisa Kato, Ryohkan Funakoshi
We evaluated the impact of pharmacist-led heart failure (HF) drug recommendations during hospitalization for hospitalized patients with HF. Hospitalized patients with HF were retrospectively reviewed. Patients were hospitalized before (n = 208, non-intervention group) or after (n = 170, intervention group) the launch of the HF multidisciplinary team (HFMDT) approach with pharmacist-led HF medication optimization. There were no significant group differences in patient background characteristics at admission...
December 4, 2017: Heart and Vessels
Carlos de Diego, Luis González-Torres, José María Núñez, Raúl Centurión Inda, David A Martin-Langerwerf, Antonio D Sangio, Piotr Chochowski, Pilar Casasnovas, Julio C Blazquéz, Jesús Almendral
BACKGROUND: Angiotensin-neprilysin inhibition compared to angiotensin inhibition decreased sudden cardiac death in patients with reduced ejection fraction heart failure (rEFHF). The precise mechanism remains unclear. OBJECTIVE: The purpose of this study was to explore the effect of angiotensin-neprilysin inhibition on ventricular arrhythmias compared to angiotensin inhibition in rEFHF patients with an implantable cardioverter-defibrillator (ICD) and remote monitoring...
March 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Noemi Pavo, Georg Goliasch, Raphael Wurm, Johannes Novak, Guido Strunk, Mariann Gyöngyösi, Marko Poglitsch, Marcus D Säemann, Martin Hülsmann
BACKGROUND: Blockade of the renin-angiotensin system (RAS) represents a main strategy in the therapy of heart failure with reduced ejection fraction (HFrEF), but the role of active renin concentration (ARC) for guiding therapy in the presence of an RAS blockade remains to be established. This study assessed angiotensin profiles of HFrEF patients with distinct RAS activations as reflected by ARC. METHODS: Two cohorts of stable chronic HFrEF patients on optimal medical treatment (OMT) were enrolled...
November 14, 2017: Clinical Chemistry
Karen Sliwa, Alexandre Mebazaa, Denise Hilfiker-Kleiner, Mark C Petrie, Aldo P Maggioni, Cecile Laroche, Vera Regitz-Zagrosek, Maria Schaufelberger, Luigi Tavazzi, Peter van der Meer, Jolien W Roos-Hesselink, Petar Seferovic, Karin van Spandonck-Zwarts, Amam Mbakwem, Michael Böhm, Frederic Mouquet, Burkert Pieske, Roger Hall, Piotre Ponikowski, Johann Bauersachs
AIMS: The purpose of this study is to describe disease presentation, co-morbidities, diagnosis and initial therapeutic management of patients with peripartum cardiomyopathy (PPCM) living in countries belonging to the European Society of Cardiology (ESC) vs. non-ESC countries. METHODS AND RESULTS: Out of 500 patients with PPCM entered by 31 March 2016, we report on data of the first 411 patients with completed case record forms (from 43 countries) entered into this ongoing registry...
September 2017: European Journal of Heart Failure
Julia D J Thomas, Abhishek Dattani, Filip Zemrak, Thomas Burchell, Scott A Akker, Felicity J L Kaplan, Bernard Khoo, Simon Aylwin, Ashley B Grossman, L Ceri Davies, Márta Korbonits
Blockade of the angiotensin-renin system, with angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), has been shown to improve cardiac outcomes following myocardial infarction and delay progression of heart failure. Acromegaly is associated with a disease-specific cardiomyopathy, the pathogenesis of which is poorly understood.The cardiac indices of patients with active acromegaly with no hypertension (Group A, n=4), established hypertension not taking ACEi/ARBs (Group B, n=4) and established hypertension taking ACEi/ARBs (Group C, n=4) were compared using cardiac magnetic imaging...
February 6, 2017: Experimental and Clinical Endocrinology & Diabetes
Noémi Nyolczas, Krisztina Heltai, Attila Borbély, Tamás Habon, Zoltán Járai, Erzsébet Sziliczei, Péter Stadler, Réka Faludi, Béla Herczeg, Előd Papp, Ferenc Lakatos, Katalin Nagy, András Katona, Imre Kovács, János Tomcsányi, András Nagy, Róbert Sepp
Heart failure is associated with a poor prognosis despite significant advances in the pharmacological and device therapy and incurs very high cost because of frequent hospitalizations. Therefore, professional high-quality care is essential for both patients and the healthcare system. The best way to evaluate the quality of care for a particular disease is the use of disease-specific registries. Until now, there has not been a registry evaluating characteristics and management of heart failure patients in Hungary...
January 2017: Orvosi Hetilap
Pınar Kızılırmak, Yağız Üresin, Oktay Özdemir, Burçak Kılıçkıran Avcı, Lale Tokgözoğlu, Zeki Öngen
OBJECTIVE: Hypertension is the most prevalent modifiable risk factor for cardiovascular (CV) and cerebrovascular morbidity and mortality. This study aimed to assess the effects of renin-angiotensin-aldosterone system (RAAS) blockade on CV outcomes. METHODS: This study was designed according to the Preferred Reporting Items for Systemic reviews and Meta-Analyses statement. Databases were searched for articles published as of December 2014. Two sets of studies were selected...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Annabel Hickey, Jessica Suna, Louise Marquart, Charles Denaro, George Javorsky, Andrew Munns, Alison Mudge, John J Atherton
BACKGROUND: To improve up-titration of medications to target dose in heart failure patients by improving communication from hospital to primary care. METHODS: This quality improvement project was undertaken within three heart failure disease management (HFDM) services in Queensland, Australia. A structured medication plan was collaboratively designed and implemented in an iterative manner, using methods including awareness raising and education, audit and feedback, integration into existing work practice, and incentive payments...
December 1, 2016: International Journal of Cardiology
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
F Wallentin, B Wettermark, T Kahan
OBJECTIVE: To describe current antihypertensive drug therapy in Sweden in relation to gender, age, and comorbidity. DESIGN AND METHOD: By use of the Stockholm County Council database, comprising all healthcare consultations, hospitalizations and dispensed drugs for 2.1 million inhabitants living in the Greater Stockholm region in 2013, we identified all persons >20 years with a recorded diagnosis of hypertension during 2009-2013, their comorbidity, and their dispensed antihypertensive drugs during 2013...
September 2016: Journal of Hypertension
Hanna Fröhlich, Christoph Nelges, Tobias Täger, Vedat Schwenger, Rita Cebola, Johannes Schnorbach, Kevin M Goode, Syed Kazmi, Hugo A Katus, John G F Cleland, Andrew L Clark, Lutz Frankenstein
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have become cornerstones of therapy for chronic heart failure (CHF). Guidelines advise high target doses for ACEIs/ARBs, but fear of worsening renal function may limit dose titration in patients with concomitant chronic kidney disease (CKD). METHODS: In this retrospective observational study, we identified 722 consecutive patients with systolic CHF, stable CKD stage III/IV (estimated glomerular filtration rate [eGFR] 15-60 mL min(-1) 1...
August 2016: American Heart Journal
Mohan Palla, Tomo Ando, Emmanuel Androulakis, Tesfaye Telila, Alexandros Briasoulis
The purpose of this study was to assess the effects of renin-angiotensin system (RAS) inhibitors vs other antihypertensive agents on cardiovascular outcomes in hypertensive black patients. The authors performed a systematic review and meta-analysis of studies that compared the effects of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) with calcium channel blockers (CCBs), diuretics, and β-blockers in hypertensive black patients on cardiovascular outcomes. A total of 38,983 patients with a mean age of 60 years and mean follow-up of 4 years were included in our meta-analysis...
April 2017: Journal of Clinical Hypertension
Feng Wang, Cheng Peng, Guangyuan Zhang, Qing Zhao, Changyou Xuan, Meng Wei, Niansong Wang
It is occasionally observed that patients without contrast-induced nephropathy (CIN) develop kidney injury within 1-6 months after coronary angiography (CAG), termed delayed CIN or delayed kidney injury (DKI) following CAG. The present study aimed to investigate the associated risk factors of delayed CIN and its possible pathogenesis. Subjects with CAG or coronary stenting from January 2008 to December 2009 were studied. A retrospective survey on DKI after CAG was conducted and the risk factors were analyzed...
July 2016: Experimental and Therapeutic Medicine
Michele Senni, John J V McMurray, Rolf Wachter, Hugh F McIntyre, Antonio Reyes, Ivan Majercak, Peter Andreka, Nina Shehova-Yankova, Inder Anand, Mehmet B Yilmaz, Harinder Gogia, Manuel Martinez-Selles, Steffen Fischer, Zsolt Zilahi, Franco Cosmi, Valeri Gelev, Enrique Galve, Juanjo J Gómez-Doblas, Jan Nociar, Maria Radomska, Beata Sokolova, Maurizio Volterrani, Arnab Sarkar, Bernard Reimund, Fabian Chen, Alan Charney
AIMS: To assess the tolerability of initiating/uptitrating sacubitril/valsartan (LCZ696) from 50 to 200 mg twice daily (target dose) over 3 and 6 weeks in heart failure (HF) patients (ejection fraction ≤35%). METHODS AND RESULTS: A 5-day open-label run-in (sacubitril/valsartan 50 mg twice daily) preceded an 11-week, double-blind, randomization period [100 mg twice daily for 2 weeks followed by 200 mg twice daily ('condensed' regimen) vs. 50 mg twice daily for 2 weeks, 100 mg twice daily for 3 weeks, followed by 200 mg twice daily ('conservative' regimen)]...
September 2016: European Journal of Heart Failure
Michel Komajda, Stefan D Anker, Martin R Cowie, Gerasimos S Filippatos, Bastian Mengelle, Piotr Ponikowski, Luigi Tavazzi
AIMS: To assess physicians' adherence to guideline-recommended medications for the treatment of chronic heart failure (CHF) with reduced ejection fraction. METHODS AND RESULTS: QUALIFY is an international prospective observational longitudinal survey of 7092 CHF outpatients recruited 1-15 months after hospitalization for heart failure from September 2013 to December 2014 in 547 centres in 36 countries. We constructed a five-class guideline adherence score for angiotensin converting enzyme inhibitors (ACEIs), beta-blockers, angiotensin receptor blockers (ARBs), mineralocorticoid receptor antagonists, and ivabradine...
May 2016: European Journal of Heart Failure
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