Heart Failure Treatments Offer New Hope
Feb. 11, 2003 -- Nearly 5 million Americans suffer from heart failure, and their prognosis remains poor. The death rate of patients with this condition is high, but two treatments offer the promise of a better outcome for people with failing hearts.
Patients treated with beta-blocking drugs and those who got specialized pacemakers had fewer heart failure deaths than patients who did not received the treatments in two large studies reported Feb. 12 in The Journal of the American Medical Association. The findings could have a big impact on the way heart failure is treated, one expert says.
"I think we are entering a new era in the treatment of patients with heart failure, and beta-blockers and implantable devices will be integral components of therapy in the future," cardiologist Sergio L. Pinski, MD, tells WebMD. "There is now no question that these treatments prolong life."
Cardiac failure is a progressive condition that occurs when the heart muscle can no longer pump blood efficiently though the body. The heart enlarges to compensate and eventually weakens. Patients typically retain fluids, have shortness of breath, and become easily fatigued.
Beta-blocking drugs have been shown to improve quality of life and reduce deaths among patients with heart failure, but the drugs are not widely used by primary care doctors treating patients with advanced disease. Many are reluctant to give these patients beta-blockers because the potential risks during the first few months of therapy are believed to outweigh the benefits. Those risks include a lowering of blood pressure, a slowing of the heart rate, and retention of sodium -- all of which can accelerate heart failure and increase the risk of death. Many doctors also believe that the benefits of this therapy are delayed.
But in a study that included 2,289 patients with severe heart failure being treated in 21 countries, the risk of death over a 10-month period was reduced by 35% among patients who took the beta-blocker drug carvedilol compared with those who received placebo treatment.
During the first eight weeks of the study, there was no increase in cardiovascular risk in the carvedilol group. Instead, fewer patients died and fewer were hospitalized than in the placebo group. Worsening of heart failure was the only serious side effect of the drug and was reported with a similar frequency in both groups.