Landmark clinical trials demonstrate that first-line pharmacotherapies, including beta-blockers, ACE inhibitors, ARBs, and ARNIs, significantly reduce mortality and hospitalizations in heart failure.
This review highlights the historical milestones and landmark clinical trials that established beta-blockers, ACEIs, ARBs, and ARNIs as foundational guideline-directed medical therapies for heart failure.
Heart failure is a clinically complex syndrome that results due to the failure of the ventricles to function as pump and oxygenate end organs. The repercussions of inadequate perfusion are seen in the form of sympathetic overactivation and third spacing, leading to clinical signs of increased blood pressure, dyspnea, fatigue, palpitations, etc. This article provided a brief overview of the clinical syndrome of heart failure; its epidemiology, risk factors, symptoms, and staging; and the mechanisms involved in disease progression. This article also described several landmark trials in heart failure that tested the efficacy of first-line drugs such as beta-blockers, angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and the latest drugs in the field of heart failure: angiotensin receptor neprilysin inhibitors. Most studies described in this article were guideline-setting trials that revolutionized the practice of medicine and cardiology.
Gajjela et al. (Sun,) conducted a review in Heart failure. Pharmacotherapy (beta-blockers, ACEIs, ARBs, ARNIs) was evaluated. Landmark clinical trials demonstrate that first-line pharmacotherapies, including beta-blockers, ACE inhibitors, ARBs, and ARNIs, significantly reduce mortality and hospitalizations in heart failure.