Augmented Short- and Long-Term Hemodynamic and Hormonal Effects of an Angiotensin Receptor Blocker Added to Angiotensin Converting Enzyme Inhibitor Therapy in Patients With Heart Failure
Key result
Adding valsartan 160 mg BID to long-term ACE inhibitor therapy in heart failure patients significantly reduced pulmonary artery diastolic pressure (-4.7 mm Hg, P=0.013) and systolic blood pressure.
Why the study?
Does valsartan added to ACE inhibitor therapy improve hemodynamic and hormonal parameters in patients with chronic heart failure?
Population
83 symptomatic stable patients with chronic heart failure receiving long-term ACE inhibitor therapy
Comparison
Valsartan 80 mg BID or 160 mg BID added to usual… vs Placebo added to usual ACE inhibitor therapy
Design
RCT, randomly assigned, double-blind
Follow-up
4 weeks
Authors
Discussion
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Implication
Supports dual ARB-ACE inhibitor use for added hemodynamic control in HF; extends evidence of incomplete RAAS suppression by ACE inhibitors alone.
Study Design
Type
RCT (n=83)
Blinding
Double-blind
Randomization
Randomized
Structured PICO
Does valsartan added to ACE inhibitor therapy improve hemodynamic and hormonal parameters in patients with chronic heart failure?
P
Population
83 symptomatic stable patients with chronic heart failure receiving long-term ACE inhibitor therapy
I
Intervention
Valsartan 80 mg BID or 160 mg BID added to usual ACE inhibitor therapy for 4 weeks
C
Comparator
Placebo added to usual ACE inhibitor therapy
O
Outcome
Changes in pulmonary capillary wedge pressure and systolic blood pressure after the first dose and after 4 weeks of therapysurrogate
Main Result
p-value: p=0.013
Adding an angiotensin receptor blocker to standard ACE inhibitor therapy in heart failure patients provides additional hemodynamic and hormonal benefits, suggesting incomplete suppression of angiotensin II by ACE inhibitors alone.
Cite This Study
Baruch et al. (1999) conducted an RCT in chronic heart failure (n=83). valsartan vs. placebo was evaluated on Net reduction in pulmonary artery diastolic pressure at 4 weeks (p=0.013). Adding valsartan 160 mg BID to long-term ACE inhibitor therapy in heart failure patients significantly reduced pulmonary artery diastolic pressure (-4.7 mm Hg, P=0.013) and systolic blood pressure.