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[Anti-aldosterone therapy in severe heart failure].
Ned Tijdschr Geneeskd 1999; 143(34):1724-6NT

Abstract

The mortality rate among patients with severe heart failure is still very high despite treatment with loop diuretics and angiotensin-converting enzyme (ACE) inhibitors. The 'randomized aldactone evaluation study' (RALES) has shown that 25 mg spironolactone added to this treatment was safe and reduced all-cause mortality by 30% in patients with severe (previous New York Heart Association (NYHA) functional class IV) heart failure due to systolic left ventricular dysfunction. Blockade of aldosterone in these patients may be necessary to overcome so-called aldosterone escape during chronic ACE-inhibition. The beneficial effects of spironolactone may relate to enhanced diuresis, anti-arrhythmogenic properties and direct effects on the myocardium and blood vessels. At present, addition of spironolactone may be appropriate for patients with severe heart failure, whereas patients with moderate heart failure may benefit more from beta-blockade.

Authors+Show Affiliations

Academisch Ziekenhuis Vrije Universiteit, afd. Inwendige Geneeskunde, Amsterdam.No affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

dut

PubMed ID

10494316

Citation

van Guldener, C, and A J. Donker. "[Anti-aldosterone Therapy in Severe Heart Failure]." Nederlands Tijdschrift Voor Geneeskunde, vol. 143, no. 34, 1999, pp. 1724-6.
van Guldener C, Donker AJ. [Anti-aldosterone therapy in severe heart failure]. Ned Tijdschr Geneeskd. 1999;143(34):1724-6.
van Guldener, C., & Donker, A. J. (1999). [Anti-aldosterone therapy in severe heart failure]. Nederlands Tijdschrift Voor Geneeskunde, 143(34), pp. 1724-6.
van Guldener C, Donker AJ. [Anti-aldosterone Therapy in Severe Heart Failure]. Ned Tijdschr Geneeskd. 1999 Aug 21;143(34):1724-6. PubMed PMID: 10494316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Anti-aldosterone therapy in severe heart failure]. AU - van Guldener,C, AU - Donker,A J, PY - 1999/9/24/pubmed PY - 1999/9/24/medline PY - 1999/9/24/entrez SP - 1724 EP - 6 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 143 IS - 34 N2 - The mortality rate among patients with severe heart failure is still very high despite treatment with loop diuretics and angiotensin-converting enzyme (ACE) inhibitors. The 'randomized aldactone evaluation study' (RALES) has shown that 25 mg spironolactone added to this treatment was safe and reduced all-cause mortality by 30% in patients with severe (previous New York Heart Association (NYHA) functional class IV) heart failure due to systolic left ventricular dysfunction. Blockade of aldosterone in these patients may be necessary to overcome so-called aldosterone escape during chronic ACE-inhibition. The beneficial effects of spironolactone may relate to enhanced diuresis, anti-arrhythmogenic properties and direct effects on the myocardium and blood vessels. At present, addition of spironolactone may be appropriate for patients with severe heart failure, whereas patients with moderate heart failure may benefit more from beta-blockade. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/10494316/[Anti_aldosterone_therapy_in_severe_heart_failure]_ L2 - https://medlineplus.gov/heartfailure.html DB - PRIME DP - Unbound Medicine ER -