Dr. Lars H. Lund of the Karolinska Institutet in Stockholm and colleagues conducted a study to examine whether renin-angiotensin system antagonists i.e., angiotensin-converting enzyme -- ACE -- inhibitors or angiotensin receptor blockers were associated with reduced mortality in heart failure patients with preserved ejection fraction.
Up to half of patients with heart failure have normal or near-normal ejection fraction, termed heart failure with preserved ejection fraction or diastolic heart failure.
"The mortality in heart failure with preserved ejection fraction may be as high as in heart failure with reduced ejection fraction or systolic heart failure, but there is no proven therapy," the study said.
The study included 41,791 patients in the Swedish Heart Failure Registry, from 64 hospitals and 84 outpatient clinics between 2000 and 2011. Of these, 16,216 patients with heart failure with preserved ejection fraction ejection fraction of 40 percent or greater; average age, 75 years; 12,543 were treated and 3,673 were not treated.
There is currently no consensus on the use of RAS antagonists in patients with heart failure with preserved ejection fraction, the researchers said.
"In our study, use of RAS antagonists was associated with reduced all-cause mortality in a broad unselected population of patients with heart failure with preserved ejection fraction," the study author said. "Our results together with the signal toward benefit in randomized controlled trials suggest that RAS antagonists may be beneficial in patients with heart failure with preserved ejection fraction, but this should be confirmed in an appropriately powered randomized trial."
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