June 17, 1988JAMA
Relative Efficacy of Vasodilator Therapy in Chronic Congestive Heart Failure
Why the study?
Do various vasodilator agents reduce mortality and improve functional status in patients with chronic congestive heart failure?
Population
1976 patients across 28 RCTs with symptomatic chronic congestive heart failure despite digitalis and…
Comparison
Various vasodilator agents administered for 4… vs Placebo.
Design
Meta-analysis, Randomized, Placebo-controlled
Follow-up
1 month to 2 years
Authors
Discussion
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Implication
Supports prioritizing ACE inhibitors in chronic HF; confirms their unique dual benefit among vasodilators.
Structured PICO
Do various vasodilator agents reduce mortality and improve functional status in patients with chronic congestive heart failure?
P
Population
1976 patients across 28 RCTs with symptomatic chronic congestive heart failure despite digitalis and diuretic therapy; most were middle-aged men and approximately half had coronary artery disease.
I
Intervention
Various vasodilator agents (including angiotensin converting-enzyme inhibitors and hydralazine hydrochloride) administered for 4 weeks or more.
C
Comparator
Placebo.
O
Outcome
Mortality and functional status.hard clinical
ACE inhibitors are the only vasodilator agents associated with both decreased mortality and improved functional status in patients with chronic congestive heart failure.
Limitations
- The optimal timing for initiation of these agents was not established.
Cite This Study
Cynthia D. Mulrow (1988) studied this question.