Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart Failure

• Published in: The New England journal of medicine Vol. 351; no. 20; pp. 2049 - 2057
• Main Authors: Taylor, Malcolm, Taylor, Anne L, Ziesche, Susan, Yancy, Clyde, Carson, Peter, D'Agostino, Ralph, Ferdinand, Keith, Adams, Kirkwood, Sabolinski, Michael, Worcel, Manuel, Cohn, Jay N
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 11.11.2004
• Subjects: Adult; African Americans; African Continental Ancestry Group; Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Clinical trials; Double-Blind Method; Drug Combinations; Drug therapy; Drug Therapy, Combination; Female; General aspects; Heart; Heart Failure - drug therapy; Heart Failure - ethnology; Heart Failure - mortality; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Hydralazine - adverse effects; Hydralazine - therapeutic use; Isosorbide Dinitrate - adverse effects; Isosorbide Dinitrate - therapeutic use; Male; Medical sciences; Middle Aged; Nitric Oxide Donors - adverse effects; Nitric Oxide Donors - therapeutic use; Quality of Life; Survival Analysis; Treatment Outcome; Vasodilator Agents - adverse effects; Vasodilator Agents - therapeutic use; Antianginal agent; Heart failure; Medicine; Isosorbide dinitrate; Coronary vasodilator agent; Heart disease; Organic nitrate; Cardiovascular disease; Antihypertensive agent; Hydralazine
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa042934

This clinical trial, in which the study group was made up of black patients with heart failure, showed that the combination of isosorbide dinitrate and hydralazine significantly improves survival when added to standard therapy for heart failure. In this clinical trial of black patients with heart failure, the combination of isosorbide dinitrate and hydralazine significantly improved survival when added to standard therapy. Neurohormonal inhibitors alone or in combination slow the progression of left ventricular dysfunction, retarding the structural remodeling of the left ventricle that characterizes chronic heart failure and reducing the rates of death and complications among patients with heart failure. 1 – 10 Endothelial dysfunction, impaired bioavailability of nitric oxide, and increased oxidant stress also occur in patients with congestive heart failure and contribute to the remodeling process in experimental and clinical models of heart failure. 11 – 27 Augmentation of nitric oxide may therefore be an alternative or supplemental approach to slow or reverse progressive heart failure. The first Vasodilator Heart Failure Trial (V-HeFT . . .