Role of secondary prevention in congestive heart failure due to coronary artery disease.
Preventing the progression of established heart failure can be difficult, as multiple factors contribute to the continual decline of cardiac function. Blunting the activated neurohormonal response to a decreased systolic function is a proven means of slowing progression of CHF. Preventing further CAD and cardiac ischemia may also prove to be an effective mechanism. Two trials with HMGCoA reductase inhibitors lend support to this hypothesis. Studies using ACE inhibitors may also support this notion. Since a major portion of heart failure in the USA is caused by CAD, preventing CHF progression may be related to the prevention of CAD. Using ACE inhibitors and lipid-lowering agents, in addition to standard measures of CAD risk factor modification, may prove useful in future trials to retard the progression of heart failure. Further research and clinical trials involving this method of CHF prevention are warranted.
Brook
R D
RD
Department of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA.
Greenland
P
P
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000150:complications* / Q000401:mortality / Q000517:prevention & control; D018450:Disease Progression; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D011379:Prognosis; D015996:Survival Rate
D000806:Angiotensin-Converting Enzyme Inhibitors; D000960:Hypolipidemic Agents