Blood Pressure Drug Helps Those With Mild Heart Failure
SUNDAY May 22, 2011 -- New Swedish research suggests that the drug Inspra reduces the threat of major cardiovascular complications among patients who have a mild form of heart failure.
This latest finding builds on earlier work that was published by the New England Journal of Medicine last fall. That study suggested that Inspra (eplerenone), an aldosterone antagonist, helps control cardiovascular complications among patients with a history of serious chronic heart failure.
Since far more people suffer from mild heart failure, this new finding could mean the drug might benefit a far broader group of patients, the researchers added.
The Swedish analysis makes an even stronger case for the use of Inspra in patients with mild heart failure because, in addition to reducing mortality, it also reduces the incidence of the irregular heart beat condition known as atrial fibrillation, study co-author Karl Swedberg, from the University of Gothenburg in Sweden, said in a news release from the European Society of Cardiology.
Atrial fibrillation "is a condition which both increases morbidity and complicates the care of patients with heart failure," he explained.
Swedberg and his colleagues were slated to present the findings Sunday in Gothenburg at the Heart Failure Congress 2011, organized by the Heart Failure Association of the European Society of Cardiology.
The study team noted that Inspra is currently approved for the control of high blood pressure as well as for the treatment of heart attack patients who experience congestive heart failure. It is not yet approved for the treatment of patients who experience mild heart failure. It is available generically in the United States, according to the news release.
Experts estimate that almost 6 million people in the United States suffer from heart failure.
The current finding stems from a re-analysis of a larger study that involved more than 2,700 heart failure patients being cared for at 278 different health centers.
Focusing specifically on those participants who had experienced mild (class 2) heart failure, the authors found that just 2.7 percent of those patients who were placed on a regimen of between 25 milligrams to 50 milligrams daily of Inspra for a little less than two years experienced atrial fibrillation.
This compared with 4.5 percent of those patients who were randomized to receive a sugar pill instead.
Dr. Byron K. Lee, director of the Electrophysiology Laboratories and Clinics within the division of cardiology at the University of California, San Francisco, noted that exactly how Inspra seems to help heart patients is not well understood.
"It is unclear how eplerenone works to lower the risk of abnormal heart rhythms like atrial fibrillation and atrial flutter," he said. "However, there are many potential mechanisms. One possibility is that eplerenone may help maintain potassium levels. Patients with heart failure are often on high-dose diuretics that remove fluid at the expense of removing potassium. Thats why heart failure patients need to watch their potassium level vigilantly."
For more on atrial fibrillation, go to National Library of Medicine.
Posted: May 2011