Evidence for the survival benefit of neurohormonal antagonists in the management of geriatric congestive heart failure.
The prevalence of congestive heart failure (CHF) doubles with each decade after the fourth decade. CHF is associated with significant mortality and morbidity. Renin-angiotensin-aldosterone and sympathetic nervous systems play a pivotal role in the progression and deterioration of CHF. Multiple, double-blinded, randomized and placebo-controlled trials have shown significant survival benefit and improved quality of life with the use of neurohormonal antagonists, viz. angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor type 1 blockers, beta-blockers and spironolactone in the management of CHF. While important for the symptom control, diuretics and digoxin are not associated with any decrease in mortality in patients with CHF. Despite overwhelming evidence of decreased mortality and morbidity, neurohormonal antagonists remain under-utilized in the management of CHF. This article will review the current evidence for the survival benefit with the use of neurohormonal antagonists in CHF.
Firdaus
Muhammad
M
Donald W Reynolds Department of Geriatrics, Oklahoma University, USA. drfirdaus@hotmail.com
Bukhari
Nasreen
N
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000037:antagonists & inhibitors* / Q000627:therapeutic use*; D015996:Survival Rate
D018377:Neurotransmitter Agents