Norgard Nicholas B, Stark Jennifer E
Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma, Oklahoma City, Oklahoma, USA.
Pharmacotherapy. 2008 Jul;28(7):920-31. doi: 10.1592/phco.28.7.920.
Angiotensin-converting enzyme (ACE) inhibitors and beta-blockers make up the cornerstone of therapy for patients with heart failure involving left ventricular dysfunction. These drug classes have been proven to decrease morbidity and mortality in patients with heart failure. Unfortunately, many patients remain symptomatic and experience disease progression despite taking both an ACE inhibitor and a beta-blocker. Others may be unable to tolerate one or both of these agents. In recent years, several other drug classes have been shown to provide additional morbidity and mortality benefits in patients with heart failure. These include angiotensin II receptor blockers (ARBs), aldosterone antagonists, and the combination of isosorbide dinitrate plus hydralazine. To select the most appropriate drug therapy for patients with heart failure, clinicians should consider results from clinical trials in specific patient populations, adverse-event profiles, tolerability, cost, and dosing regimens.
血管紧张素转换酶（ACE）抑制剂和β受体阻滞剂是治疗伴有左心室功能障碍的心力衰竭患者的基石。这些药物类别已被证明可降低心力衰竭患者的发病率和死亡率。不幸的是，许多患者尽管同时服用了ACE抑制剂和β受体阻滞剂，仍有症状并经历疾病进展。其他患者可能无法耐受其中一种或两种药物。近年来，其他几类药物已被证明可为心力衰竭患者带来额外的发病率和死亡率益处。这些药物包括血管紧张素II受体阻滞剂（ARB）、醛固酮拮抗剂以及硝酸异山梨酯加肼屈嗪的组合。为心力衰竭患者选择最合适的药物治疗时，临床医生应考虑特定患者群体的临床试验结果、不良事件概况、耐受性、成本和给药方案。
