Vasodilators are here to stay In congestive heart failure

' ... Vasodilators can nOHl be considered one of the three cornerstones of the pharmacologic treatment of heart failure, and ACE inhibitors ' ... appear to be the vasodilators of choice . .. ' Support for these conclusions comes from the first Veterans Administration Cooperative Vasodilator-Heart Failure trial (V-HeFT I) [see lnpharma 546: 19 Jul 1986. plO]. from the CONSENSUS I trial [see lnpharma 592: 20 Jun 1987. p7], from the V -HeFT II [see Therapy section. this issue. p8] and from the Studies of Left Ventricular Dysfunction [see Therapy section. this issue. p8].

Of note. the results of the V-HeFT II have shown that enalapril is likely to be superior to nonspecific vasodilators (e.g. hydralazine + nitrate); further, ACE inhibitors have also been observed to induce regression of ventricular hypertrophy in animal models and to have anti­ischaemic properties. The ongoing study of the addition of flosequinan to an ACE inhibitor will answer the question of whether the efficacy of ACE inhibitors can be increased by the addition of another vasodilator. Future research has begun to focus on whether ACE inhibitors are also indicated in patients with left ventricular dysfunction and heart disease who are not in overt heart failure. Braunwald E. ACE inhibitors-A cornerstone of the treatment of heart failure. New England Journal of Medicine 315: 351-353. I Aug 1991,,,,,,

ISSN 0156-1703/91/0810-0001/0S01.00/0 Ii:> Adis l"tl!rtUltiolUll Ltd

1 INPH.4RMA®10 Allg 1991 _