Turning to Drugs for Heart Failure
While there have been setbacks in recent research, drugs remain the most common effective heart-failure treatment.
Aldosterone Blockers continued...
While the reduction in side effects is important, the greater significance of the study, according to Pitt, is that it demonstrates the importance of blocking aldosterone. The most recent study testing Inspra is the second that shows aldosterone blockade makes a difference, Pitt tells WebMD. "There were a lot of people on the fence before, and I think this study will lead to more clinical investigation."
More study of Inspra is needed since this drug has largely been studied in people who had suffered from a recent heart attack and not heart failure. But the results are exciting for people with heart failure, according to Konstam. "In the last 10 years of drug therapy, there have been three big stories," he says. "First were the ACE Inhibitors, then the beta-blockers in the mid-90s, and now the aldosterone [blockers]."
Aggressive Heart-Failure Treatment
Experts are consistently stressing the importance of treating heart failure aggressively.
If you look at the heart-failure trials over the last 15 years, combining ACE inhibitors, and beta-blockers with devices used in heart-failure treatment, the rate of death has dropped 68%, says Bristow. "That's spectacular progress."
"But that's only progress in clinical trials," Bristow tells WebMD. "The problem is that these effective treatments are not getting out to the community. There continue to be only about 50% to 60% of patients who should be on ACE inhibitors who are actually on them, and 30% to 40% of the people who should be using beta-blockers who are actually are."
Part of the problem is that beta-blockers can cause side effects and getting the right dosage can be difficult. As a result, doctors may be reluctant to prescribe them.
"Side effects can be problematic with beta-blockers since they can actually make you feel worse," says Susan Bennett, RN, DNS, an Indiana University nursing school professor.
Still, experts generally agree that heart-failure treatment has become more aggressive in recent years as the message has gotten to physicians. "Sure, there's always room for improvement," says Konstam. "But I see positive trends in the speed with which clinicians respond to new treatment information."