Medications
Many different medications are used in the treatment of heart failure. They include:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin-receptor blockers (ARBs)
- Beta blockers
- Diuretics
- Aldosterone blockers
- Digitalis
- Hydralazine and nitrates
- Statins
- Nesiritide (Natrecor)
- Aspirin
ACE Inhibitors
Angiotensin-converting enzyme (ACE) inhibitors are among the most important drugs for treating patients with heart failure. ACE inhibitors open blood vessels and decrease the workload of the heart. They are used to treat high blood pressure but can also help improve heart and lung muscle function. Major studies suggest that ACE inhibitors may reduce the risk of death, heart attack, and hospital admissions by 28% in patients with existing heart failure.
ACE inhibitors are particularly important for patients with diabetes. A large study reported that diabetic patients who took these drugs had fewer heart attacks and lower overall mortality rates than patients who took other types of high blood pressure medications. ACE inhibitors may also help slow progression of kidney disease, in addition to controlling blood pressure.
Doctors sometimes avoid giving aspirin to patients who are taking ACE inhibitors due to concerns that this drug combination can cause kidney problems. A 2005 study of patients with both coronary artery disease and heart failure indicated that an aspirin and ACE inhibitor combination is not harmful, and that aspirin can significantly reduce mortality risk for these patients.
Choosing an ACE inhibitor. ACE inhibitors treat Stage A high-risk conditions such as high blood pressure, heart disease, and diabetic nerve disorders (neuropathy). They also treat Stage B patients who have had a heart attack or who have left ventricular systolic disorder, and Stage C patients with heart failure. Specific brands and stages include:
- Benazepril (Lotrel) – (Stage A)
- Captopril (Capoten) – (Stages A, B, C)
- Enalapril (Vasotec) – (Stages A, B, C)
- Fosinopril (Monopril) – (Stages A, C)
- Lisinopril (Prinivil, Zestril) – (Stages A, B, C)
- Moexipril (Univasc) – (Stage A)
- Perindopril (Aceon) – (Stage A)
- Quinapril (Accupril) – (Stages A, C)
- Ramipril (Altace) – (Stages A, B, C)
- Trandolapril (Mavik) – (Stages A, B, C)
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