Medical Therapy for Chronic Congestive Heart Failure

Excerpt

Congestive heart failure remains a common final manifestation of ischemic, valvular, hypertensive, and myocardial disease. In the United States alone an estimated 400 000 persons develop congestive heart failureannually (1), and the prognosis of those with symptomatic heart failure remains very poor (1, 2). Five years ago, diuretics were used as the initial theraphy of congestive heart failure in the absence of randomized trials showing improvement in either symptoms or ultimate outcome. Vasodilators were considered a third-line drug (after diuretics and digitalis) and a number of vasodilators were possible choices. Digoxin was used as first- or second-line therapy without its