Can we expect vasodilator therapy to prolong life in patients with congestive heart failure?

M. Packer, W. H. Lee, P. D. Kessler, S. S. Gottlieb

Research output: Contribution to journalArticlepeer-review


Recent evidence from the Veterans Administration Vasodilator Heart Failure Trial supports the prophylactic use of a combination of hydralazine and isosor-bide dinitrate to prolong life in patients with congestive heart failure. The clinical utility of such a combination vasodilator regimen may be limited, however, by its high frequency of adverse reactions, the lack of evidence that such a regimen enhances exercise tolerance, the inconvenience of taking a large number of tablets daily for a prophylactic indication, and the dearth of clinical experience combining hydralazine-nitrate with agents that may be clinically indicated to produce long-term symptomatic benefits (i.e., converting-enzyme inhibitors). Controlled evidence in animals and uncontrolled evidence in humans suggest that converting-enzyme inhibitors may also favorably modify prognosis, perhaps by antagonizing the deleterious actions of endogenous neurohormonal systems. Trials (presently in progress) are designed to evaluate the hypothesis that converting-enzyme inhibitors exert beneficial effects on the survival of patients with congestive heart failure comparable to those reported with hydralazine and isosorbide dinitrate.

Original languageEnglish (US)
Pages (from-to)S73-S75
JournalJournal of Cardiovascular Pharmacology
StatePublished - 1987


  • Congestive heart failure
  • Vasodilator therapy

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine


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