1. Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin II
Receptor Blockers (ARBs) are two groups of drugs that improve
symptoms by decreasing blood pressure and improving blood flow from
the heart to the vessels. Both groups have shown improvement in survival
when used in patient with CHF, nevertheless, ACE inhibitors may be
slightly more effective than ARBs [10,11,12]. ACE inhibitors should be used
as first line therapy; however, side effects like cough, worsening kidney
function, or increasing blood potassium levels might develop and limit their
use.
2. Beta blockers decrease the heart muscle’s requirement for oxygen and
heart rate. Some of the beta blockers are selective to the heart muscle,
like carvedilol, metoprolol, and bisoprolol. These medications have shown
substantial improvement in survival of all classes of heart failure and
should be added to ACE inhibitors in all patients with heart failure if
tolerated [13].
3. Spironolactone and eplerenone are aldosterone antagonists that prolong
survival in patients with moderate to severe heart failure [14]. Eplerenone
has less endocrine side effects than spironolactone, nevertheless, both
might increase potassium levels and should be used with caution in
patients with renal failure.
4. Diuretics are used to control symptoms of fluid retention related to heart
failure, with furosemide being the most commonly used drug. Diuretics
might improve symptoms associated with HF like shortness of breath and
ankle edema, however, no decrease in mortality was observed with the
use of these drugs.
1. Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin IIReceptor Blockers (ARBs) are two groups of drugs that improvesymptoms by decreasing blood pressure and improving blood flow fromthe heart to the vessels. Both groups have shown improvement in survivalwhen used in patient with CHF, nevertheless, ACE inhibitors may beslightly more effective than ARBs [10,11,12]. ACE inhibitors should be usedas first line therapy; however, side effects like cough, worsening kidneyfunction, or increasing blood potassium levels might develop and limit theiruse.2. Beta blockers decrease the heart muscle’s requirement for oxygen andheart rate. Some of the beta blockers are selective to the heart muscle,like carvedilol, metoprolol, and bisoprolol. These medications have shownsubstantial improvement in survival of all classes of heart failure andshould be added to ACE inhibitors in all patients with heart failure iftolerated [13].3. Spironolactone and eplerenone are aldosterone antagonists that prolongsurvival in patients with moderate to severe heart failure [14]. Eplerenonehas less endocrine side effects than spironolactone, nevertheless, bothmight increase potassium levels and should be used with caution inpatients with renal failure.4. Diuretics are used to control symptoms of fluid retention related to heartfailure, with furosemide being the most commonly used drug. Diureticsmight improve symptoms associated with HF like shortness of breath andankle edema, however, no decrease in mortality was observed with theuse of these drugs.
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