Management of Heart Failure

Published In: JAMA, The Journal of the American Medical Association, v. 272, no. 17, Nov. 2, 1994, p. 1361-1366

Posted on RAND.org on January 01, 1994

by David William Baker, Marvin A. Konstam, Michael Bottorff, Bertram Pitt

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Deals with pharmacological treatment of congestive heart failure (CHF). It concludes that angiotensin-converting-enzyme (ACE) inhibitors should be given to all patients who have experienced heart failure unless specific contraindications exist. Diuretics should be used judiciously early in treatment to prevent excess diuresis. Digoxin has not been shown to affect the natural history of heart failure, and isosorbide dinitrate and hydralazine hydrochloride should be tried in patients who cannot tolerate ACE inhibitors or who have refractory symptoms.

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