Symptoms and exercise tolerance have been the major therapeutic end points of most previous trials, but the effect of vasodilator drugs on mortality has not been adequately examined. THE demonstration of a favorable hemodynamic response to vasodilator drugs in patients with congestive heart failure has led to the wide use of these agents to supplement digitalis and diuretics in the treatment of symptomatic patients. For mortality by two years, a major end point specified in the protocol, the risk reduction among patients treated with both hydralazine and isosorbide dinitrate was 34 percent (P. This difference was of borderline statistical significance. Mortality over the entire follow-up period was lower in the group that received hydralazine and isosorbide dinitrate than in the placebo group. Follow-up averaged 2.3 years (range, 6 months to 5.7 years). Abstract To evaluate the effects of vasodilator therapy on mortality among patients with chronic congestive heart failure, we randomly assigned 642 men with impaired cardiac function and reduced exercise tolerance who were taking digoxin and a diuretic to receive additional double-blind treatment with placebo, prazosin (20 mg per day), or the combination of hydralazine (300 mg per day) and isosorbide dinitrate (160 mg per day). Shah, M.D., Robert Saunders, M.D., Ross D. Flohr, M.D., Steven Goldman, M.D., Frederick R. Bruce Dunkman, M.D., William Jacobs, M.D., Gary S.įrancis, M.D., Kathleen H. Cohn, M.D., Donald G.Īrchibald, M.Phil., Susan Ziesche, R.N., Joseph A. Original Article Effect of Vasodilator Therapy on Mortality in Chronic Congestive Heart Failure Jay N.
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