Pharmacotherapy for chronic heart failure.
BACKGROUND
Heart failure is a chronic and progressive disorder which results due to inability of the heart to pump adequate blood to meet up the metabolic demands of the body. Detecting patients with heart failure could be simple but rather complex of clinical decisions as presentation could be classical or non-specific with minimal symptoms and orsigns. Management is aimed at relieving symptoms, improving quality of life, preventing hospitalisation and arresting disease progression thus prolonging survival. In addition to pharmacologic measures, non-pharmacologic ones are also employed.


METHODS
Relevant literature was reviewed using medical journals and also via internet. The key words employed were: Heart failure, Chronic heart failure, Diuretics, Vasodilators, Angiotensin receptor blockers (ARBS) and Angiotensin converting enzyme inhibitors (ACEI). The National Heart, Lung and Blood Institute, Canadian Cardiovascular Society, American College of Cardiology websites were also used in the course of this review.


RESULTS
This review was able to support the use of betablockers, ACEI, ARBS, digitalis, diuretics, vasodilators and aldosterone antagonists in the management of chronic heart failure.


CONCLUSIONS
The objectives of drug therapy in heart failure includes the short-term goals of stabilising the patient, improving haemodynamic function and conferring symptomatic improvement, as well as the long-term goal of limiting disease progression, decreasing hospital re-admission rates and improving survival. The cause needs to be established and aggravating factors identified (and where possible treated). Most of the drugs, if not all, are used in combination with one another to achieve maximal therapeutic goal. Use of some drugs could be entertained as an add-on therapy depending on any co-existing medical condition.
Saleh
J A
JA
Dept. Of Medicine, Imperial College, Hammersmith Hospital, London. drjalals@yahoo.com
Aji
B M
BM
Yusuph
H
H
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D011945:Receptors, Angiotensin / Q000187:drug effects
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D004232:Diuretics; D011945:Receptors, Angiotensin