It is well established that the use...

It is well established that the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-II receptor blocker (ARBs) improve survival in patients with systolic dysfunction. However, the part of these agents in treating ones with heart failure and diastolic dysfunction is les clear. To meditation the effects of posthospitalization use of ACE inhibitors or ARB agents in succession survival rates after discharge, Sueta and associates actionsed a retrospective case review of patients who were at least 65 years of age and hospitalized for heart failure.

Diastolic dysfunction was defined as preserv left ventricular function with ventricular ejection fraction of 50 percent or greater or the carriage of qualitatively normal ventricular contractions assessed using echocardiography, radionuclide ventriculography, or contrast ventriculography. The demographics and comorbidities of the patients who were discharged while receiving an ACE inhibitor or ARB agent were similar to those who did not receive these medications. Although more of the treated clump had diabetes or a history of hypertension, renal function was significantly worse in patients who were not receiving common of the medications.

Within single in kind year of discharge, 27 percent of the patients with diastolic dysfunction had died. Eighty-six patients (22 percent) in the dispose discharged on an ACE inhibitor or ARB died, compared with 122 patients (34 percent) who were not receiving these agents at discharge. Patients who were discharged forward one of these agents were 68 percent more likely to be alive united year after hospitalization.

The authors determine that discharge of older patients with normal ventricular function following hospitalization for heart failure with ACE inhibitors or ARB agents is an independent predictor of increased one-year survival. This is consistent with other studies that construct that blocking the renin-angiotensin connected view improves New York Heart Association class and exercise tolerance in patients with heart failure secondary to diastolic dysfunction.

Sueta CA, et al. weight of angiotensin-converting inhibitor or angiotensin receptor blocker upon one-year survival in patients 65 years hospitalized with a left ventricular ejection fraction 50% Am J Cardiol February 1 2003; 91:363-5

COPYRIGHT 2003 American Academy of Family Physicians

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