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How should we manage heart failure developing in patients already treated with angiotensin-converting enzyme inhibitors and beta-blockers for hypertension, diabetes or coronary disease
Journal of Hypertension, 07/29/2010
Gustafsson F et al. – An increasing number of patients in the community are being treated with angiotensin–converting enzyme inhibitors, angiotensin receptor blockers and beta–blockers for hypertension, coronary disease or diabetic renal and vascular complications. Some of these patients will develop heart failure despite such treatment. Based on data from hypertension trials it can be estimated that approximately 5% of treated patients will develop heart failure over 5 years. It is unclear whether patients developing heart failure on and off ACE–inhibitors or beta–blockers, respectively, at the time of heart failure diagnosis have similar prognosis. Treatment options for patients developing heart failure while already treated with ACE inhibitors/ARBs and beta–blockers are very limited if current heart failure guidelines are followed.
