The treatment of chronic heart failure by drugs

Journal of Clinical and Basic Cardiology 2000; 3 (3): 163-166

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Keywords: chronische Herzinsuffizienz,  medikamentöse Therapie,  Morbidität,  Mortalität,  Symptom,  chronic heart failure,  drug treatment,  morbidity,  mortality,  symptoms

In thirteen placebo controlled studies with reduction of total mortality there was no strict correlation between the improvement of symptoms and morbidity and the reduction of mortality. Either the reduction of mortality or the improvement of symptoms or morbidity are reliable endpoints for each other. Only spironolactone in the RALES-study showed a consistency for improving symptoms and morbidity and reduction of mortality. However, the minimal challenge for the treatment of the life threatening disease chronic heart failure is the improvement of symptoms and morbidity without reduction of life expectancy. Spironolactone, enalapril and bisoprolol can be recommended for the improvement of all three endpoints, whilst for carvedilol there is only evidence for the reduction of morbidity and mortality, for metoprolol and the combination of hydralazine and isosorbiddinitrate for the reduction of mortality and digoxin for the reduction of morbidity. For amlodipine there is no proof of the improvement of symptoms, morbidity and mortality. J Clin Basic Cardiol 2000; 3: 163-166