BP Drug Can Prevent Heart Failure

Feb. 24, 2003 -- Drugs used to treat heart failure can also prevent the condition from occurring. In newly published research, high-risk patients treated with a widely prescribed ACE inhibitor were 23% less likely to develop heart failure than patients who were not treated.

The research confirms that ACE inhibitors can have a significant impact on death and disability from heart failure, even among patients who have no evidence of heart damage, says lead researcher and cardiologist J. Malcolm Arnold, MD. Although patients in the study had cardiovascular disease, they had no history of heart failure and still had normal heart pumping function.

"This shows that aggressive early treatment is important for a broad range of patients, and that (ACE inhibitors) have benefits that go beyond preventing heart attacks and strokes," Arnold tells WebMD.

Nearly 5 million Americans suffer from heart failure, in which the weakened or damaged heart can no longer pump blood effectively through the body. Millions more are at risk for developing the condition due to factors such as high blood pressure, diabetes, obesity, and prior heart attacks. Once diagnosed, the chance of dying from heart failure within one year is 20%-50%.

ACE inhibitors work by widening the blood vessels to help improve blood flow. They also help block a blood vessel-constricting chemical called angiotensin, which is produced in people with heart disease and may cause worsening of the disease.

In this study, Arnold and colleagues evaluated the usefulness of the ACE inhibitor Altace in preventing heart failure among high-risk patients whose hearts still pumped normally. Their findings are reported in the March 11 issue of the American Heart Association journal Circulation.

The researchers evaluated data from a study of 9,297 patients treated with either Altace or placebo for four-and-a-half years. More than half of the participants (53%) had a previous heart attack, 47% had a history of high blood pressure, and 38% had diabetes. None had evidence of heart failure or uncontrolled high blood pressure. The average age of the participants was 66, and 73% were men.

During the study period, 1,029 patients suffered heart attacks. Those treated with the ACE inhibitor had a 13% lower risk of subsequent heart failure.

Treatment with the ACE inhibitor was found to reduce the rate of heart attacks by 22% among the remaining patients.

The benefit was even greater for patients with high blood pressure at the start of the study. These patients saw a 33% reduction in heart failure risk. Patients who had only moderately high blood pressure saw a 10% reduction.

"This suggests that reducing blood pressure, even when it is only modestly above normal, can have a significant impact on the risk of developing heart failure," says Arnold.