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heart failure ace arb

Kelsie E Oatmen, Michael R Zile, John C Burnett, Francis G Spinale
Importance: The standard pharmacotherapy for heart failure (HF), particularly HF with reduced ejection fraction (HFrEF), is primarily through the use of receptor antagonists, notably inhibition of the renin-angiotensin system by either angiotensin-converting enzyme inhibition or angiotensin II receptor blockade (ARB). However, the completed Prospective Comparison of ARNI With an ACE-Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial identified that the use of a single molecule (sacubitril/valsartan), which is an ARB and the neutral endopeptidase inhibitor (NEPi) neprilysin, yielded improved clinical outcomes in HFrEF compared with angiotensin-converting enzyme inhibition alone...
November 28, 2018: JAMA Cardiology
Yu Jie Chen, Liang Jin Li, Wen Lu Tang, Jia Yang Song, Ru Qiu, Qian Li, Hao Xue, James M Wright
BACKGROUND: This is the first update of a Cochrane Review first published in 2015. Renin angiotensin system (RAS) inhibitors include angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and renin inhibitors. They are widely prescribed for treatment of hypertension, especially for people with diabetes because of postulated advantages for reducing diabetic nephropathy and cardiovascular morbidity and mortality. Despite widespread use for hypertension, the efficacy and safety of RAS inhibitors compared to other antihypertensive drug classes remains unclear...
November 14, 2018: Cochrane Database of Systematic Reviews
Kathir Balakumaran, Aadhar Patil, Shannon Marsh, Joseph Ingrassia, Chia-Ling Kuo, Daniel Louis Jacoby, Sabeena Arora, Richard Soucier
Introduction: Heart failure is associated with recurrent hospitalizations and high mortality. Guideline directed medical treatment (GDMT), including beta blockers (BBs), angiotensin converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs) and aldosterone antagonists (AAs) has shown to improve outcomes. Current guidelines recommend the use of these medication classes at maximally tolerated dosages. Despite the evidence, < 25% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) are on the appropriate medical regimen titrated to the target doses...
March 2019: IJC Heart & Vasculature
J Kuschyk, B Rudic, V Liebe, E Tülümen, M Borggrefe, I Akin
The worldwide prevalence of heart failure is 1-2% with a portion of >10% in patients older than 70 years. In addition to treatment of causal determined factors and lifestyle modification, basic treatment consists of guideline-directed medical therapy with angiotensin-converting enzyme inhibitors (ACE), β‑blockers (BB), mineralocorticoid receptor antagonists (MRA), diuretics, digitalis (class IIb recommendation), angiotensin receptor blockers (ARB), Iƒ-channel blockers plus recently recommended in the guidelines angiotensin receptor neprilysin inhibitor (ARNI) to substitute the ACE inhibitor (class I b)...
December 2018: Herzschrittmachertherapie & Elektrophysiologie
Nam-Kyoo Lim, Sang Eun Lee, Hae-Young Lee, Hyun-Jai Cho, Won-Seok Choe, Hokon Kim, Jin Oh Choi, Eun-Seok Jeon, 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, Myeong-Chan Cho, Byung-Hee Oh, Hyun-Young Park
BACKGROUND: Identifying patients with acute heart failure (HF) at high risk for readmission or death after hospital discharge will enable the optimization of treatment and management. The objective of this study was to develop a risk score for 30-day HF-specific readmission or death in Korea. METHODS: We analyzed the data from the Korean Acute Heart Failure (KorAHF) registry to develop a risk score. The model was derived from a multiple logistic regression analysis using a stepwise variable selection method...
October 22, 2018: Journal of Cardiology
Adam D DeVore, C Larry Hill, Laine Thomas, Puza P Sharma, Nancy M Albert, Javed Butler, J Herbert Patterson, John A Spertus, Fredonia B Williams, Carol I Duffy, Kevin McCague, Adrian F Hernandez, Gregg C Fonarow
Background Current guidelines recommend sacubitril/valsartan for patients with heart failure with reduced ejection fraction, but the rate of adoption in the United States has been slow. Methods and Results Using data from CHAMP-HF (Change the Management of Patients With Heart Failure), we described current sacubitril/valsartan use and identified patient, provider, and practice characteristics associated with its use. We considered patients to be on sacubitril/valsartan if they were prescribed it before enrollment or initiated on it at the baseline visit...
September 2018: Circulation. Heart Failure
Michael H Chiu, Robert J H Miller, Rebecca Barry, Bing Li, Bryan J Har, Stephen B Wilton, Merril Knudtson, Jonathan G Howlett, Matthew T James
Background: Angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (ACE-I/ARB) improve outcomes in patients with heart failure and reduced left-ventricular (LV) systolic function. However, these medications can cause a rise in serum creatinine and their benefits in patients with HF accompanied by kidney disease are less certain. Objective: To characterize associations between estimated glomerular filtration rate (eGFR), patterns of ACE-Is and ARBs use, and 1-year survival following hospitalization for heart failure (HF)...
2018: Canadian Journal of Kidney Health and Disease
Cherinne Arundel, Helen M Sheriff, Phillip H Lam, Selma F Mohammed, Linda G Jones, Corrine Y Jurgens, Charity J Morgan, Charles Faselis, Richard M Allman, Gregg C Fonarow, Ali Ahmed
BACKGROUND: Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs-ARBs) improve outcomes in heart failure (HF). Less is known about this association in nursing home (NH) residents. METHODS: Of the 8024 hospitalized HF patients, 542 were NH residents, of whom 252 received ACEIs-ARBs. We assembled a propensity score-matched cohort of 157 pairs of NH residents receiving and not receiving ACEIs-ARBs balanced on 29 baseline characteristics (mean age, 3 years, 74% women, 17% African American), in which we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with ACEI-ARB use...
September 25, 2018: American Journal of Therapeutics
Pei-Yu Liu, Chien-Lin Chen, Min-Chien Yu, Yu-Lin Ko, Shun-Yi Hsu, Hsin-Hua Chou, Kuan-Hung Yeh, De-Min Duan, Ming-Hsin Chen, Jeng-Feng Lin
OBJECTIVES: In patients with ST-elevation myocardial infarction (STEMI), it is not clear whether low-dose renin-angiotensin system inhibitors and beta-blockers can result in the same benefits achievable with higher target doses. This observational study aims to investigate whether higher doses of angiotensin converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB) and beta-blockers can improve outcomes in patients with STEMI. METHODS: We recorded daily doses of ACEI, ARB, and beta-blockers in 331 patients with STEMI...
October 8, 2018: Acta Clinica Belgica
Tatsuya Morimoto, Masafumi Funamoto, Yoichi Sunagawa, Yasufumi Katanasaka, Yusuke Miyazaki, Koji Hasegawa
 Hemodynamic stresses, including hypertension and myocardial infarction, activate neurohumoral factors such as the sympathetic nervous system and the renin-angiotensin system, and can lead to the progression of heart failure. Established pharmacological agents such as angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, and β-blockers target extra-cellular molecules and receptors on the cell membrane. These agents have shown some efficacy for the treatment of heart failure, but the long-term survival rate of patients with heart failure remains low...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Abigail Khan, Emmanuelle Paré, Shimoli Shah
PURPOSE OF REVIEW: This review summarizes the pathophysiology, diagnosis, and treatment of peripartum cardiomyopathy (PPCM), with a focus on recent discoveries of clinical relevance. RECENT FINDINGS: An increase in oxidative stress and anti-angiogenic activity play key roles in the pathophysiology of peripartum cardiomyopathy. Therapies that target this dysregulation may have a future role in treatment. Suppression of prolactin release using bromocriptine, a dopamine-receptor antagonist, has been associated with more favorable outcomes in small studies but more research is needed...
September 29, 2018: Current Treatment Options in Cardiovascular Medicine
Pedro J Tárraga López, M José Villar Inarejos, Ibrahim M Sadek, Fátima Madrona Marcos, Loreto Tárraga Marcos, Miguel Ángel Simón García
OBJECTIVE: To analyse the heart failure situation in a health area, as well quality criteria. METHOD: Cross-sectional observational study of patients diagnosed with heart failure by collecting data from their clinical history in the «Turriano» computer program. The variables analysed were, comorbidities, control of cardiovascular risk factors, treatments, number of chronic diseases, and admissions. The level of adherence to drugs in relation to heart failure by determining the ratio between the percentage of prescribed drugs and drugs withdrawn from pharmacy is also analysed using the Turriano prescription program...
September 24, 2018: Clínica e Investigación en Arteriosclerosis
Ehimare Akhabue, Thanh-Huyen T Vu, Anand Vaidya, Erin D Michos, Ian H de Boer, Bryan Kestenbaum, Matthew Allison, Moyses Szklo, Pamela Ouyang, Clyde W Yancy, Myles Wolf, Tamara Isakova, Mercedes R Carnethon
Background: Higher Fibroblast Growth Factor-23 (FGF23) concentrations have been found to be associated with incident heart failure (HF). Experimental data suggest FGF23 directly stimulates myocardial hypertrophy. FGF23 may also enhance renin-angiotensin-aldosterone system activity. Whether FGF23 is associated with increased HF risk in populations with hypertension and whether this association is weaker in the presence of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy is unknown...
September 25, 2018: American Journal of Hypertension
Caroline Sirois, Carlotta Lunghi, Marie-Laure Laroche, Alicia Maheux, Anissa Frini
BACKGROUND: Clinical practice guidelines are useful to suggest pharmacological therapies for the treatment of single chronic diseases. However, there is little guidance for multimorbidity, and specific quality measures for people with multimorbidity that can be used at a population level are lacking. OBJECTIVE: To describe what pharmacists and geriatricians consider to be an optimal basic pharmacological therapy for an older individual with type 2 diabetes (DM), chronic obstructive pulmonary disease (COPD) and heart failure (HF)...
September 19, 2018: Research in Social & Administrative Pharmacy: RSAP
Monika Wieser, Daniel Rhyner, Michele Martinelli, Thomas Suter, Bruno Schnegg, Claudia Bösch, Olivier Wigger, Stephan Dobner, Lukas Hunziker
Pharmacological therapy of heart failure with reduced ejection fraction Abstract. Pharmacological therapy for heart failure has made great progress over the last three decades and evidence-based therapies have significantly improved survival and quality of life. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and beta-blockers are the cornerstone of the heart failure therapy; indicated in virtually every patient with heart failure and reduced ejection fraction. As soon as the left ventricular ejection fraction decreases below 35 % and / or symptoms are still present (NYHA II-IV), a mineralocorticoid receptor antagonist should be added...
September 2018: Therapeutische Umschau. Revue Thérapeutique
Jonathan A Batty, Mengyao Tang, Marlous Hall, Roberto Ferrari, Martin H Strauss, Alistair S Hall
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs) efficaciously reduce systolic blood pressure (BP), a well-established risk factor for myocardial infarction (MI). Both inhibit the renin-angiotensin system, albeit through different mechanisms, and produce similar reductions in BP. However, in parallel meta-analyses of ACEi and ARB trials, ACEis reduce risk of MI whereas ARBs do not-a phenomenon described as the 'ARB-MI paradox'. In addition, ACEis reduce all-cause mortality, whereas ARBs do not, which appears to be independent of BP lowering...
August 25, 2018: Systematic Reviews
Suzanne V Arnold, Jonathan Yap, Carolyn S P Lam, Fengming Tang, Wan T Tay, Tiew H K Teng, Darren K McGuire, James L Januzzi, Gregg C Fonarow, Frederick A Masoudi, Mikhail Kosiborod
AIMS: To compare the management of patients with diabetes and heart failure with reduced ejection fraction (HFrEF) in the United States and Asia to understand variations in treatment patterns across different healthcare systems. MATERIALS AND METHODS: Our cohort included patients with diabetes and HFrEF (ejection fraction <40%) from a US-based registry of adults with diabetes (2013-2016, electronic health records) and a multi-national Asian registry of adults with heart failure (2010-2016, prospective registry)...
August 23, 2018: Diabetes, Obesity & Metabolism
Ramesh R Dargad, Mahesh R Prajapati, Rohit R Dargad, Jai D Parekh
OBJECTIVE: To describe the efficacy, superiority and safety profile of the first-in-class angiotensin receptor-neprilysin inhibitor "Sacubitril/Valsartan" as compared to angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blocker (ARB) in heart failure (HF) patients, reviewing data available from both clinical and pre-clinical studies. Evidences on health care utilization outcomes such as hospitalizations and emergency department visits were also evaluated...
July 2018: Indian Heart Journal
Tiew-Hwa K Teng, Jasper Tromp, Wan Ting Tay, Inder Anand, Wouter Ouwerkerk, Vijay Chopra, Gurpreet S Wander, Jonathan Jl Yap, Michael R MacDonald, Chang Fen Xu, Yvonne Mf Chia, Wataru Shimizu, A Mark Richards, Adriaan Voors, Carolyn Sp Lam
BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists (MRAs) are of proven benefit and are recommended by guidelines for management of patients with heart failure and reduced ejection fraction (HFrEF). We aimed to examine the first prospective multinational data from Asia on prescribing patterns of guideline-directed medical therapies and analyse its effect on outcomes. METHODS: In the prospective multinational ASIAN-HF registry (with enrolment from 46 centres in 11 countries in Asia), we enrolled patients aged 18 years or older, with symptomatic heart failure (stage C, with at least one episode of decompensated heart failure in the past 6 months that resulted in admission to hospital or was treated in an outpatient clinic) and left ventricular systolic dysfunction (ejection fraction ≤40% on baseline echocardiography, consistent with 2016 European Society of Cardiology guidelines)...
September 2018: Lancet Global Health
Muaamar Al-Gobari, Sinaa Al-Aqeel, François Gueyffier, Bernard Burnand
OBJECTIVES: To summarise and synthesise the current evidence regarding the effectiveness of drug interventions to prevent sudden cardiac death (SCD) and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). DESIGN: Overview of systematic reviews. DATA SOURCES: MEDLINE, Embase, ISI Web of Science and Cochrane Library from inception to May 2017; manual search of references of included studies for potentially relevant reviews...
July 28, 2018: BMJ Open
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