Table I.
Evidence-based therapies used in heart failure [79]
| Drugs | Target^/Usual$ daily dose [mg] | Clinical trial |
|---|---|---|
| ACE inhibitor*: | ||
| Captopril | 50 t.i.d^ | SAVE (captopril) |
| Enalapril | 10–20 b.i.d.^ | CONSENSUS, SOLVD (enalapril) |
| Lisinopril | 20–35 o.d.^ | ATLAS (lisinopril) |
| Ramipril | 5 b.i.d.^ | AIRE (ramipril) |
| Trandolapril | 4 o.d.^ | TRACE (trandolapril) |
| ARB*: | ||
| Candesartan | 32 o.d.^ | CHARM (candesartan) |
| Valsartan | 160 b.i.d.^ | Val-HeFT, VALIANT (valsartan) |
| Losartan | 150 o.d.^ | HEAAL (losartan) |
| β-Blockers*: | ||
| Bisoprolol | 10 o.d.^ | CIBIS II (bisoprolol) |
| Carvedilol | 25–50 b.i.d.^ | COPERNICUS (carvedilol) |
| Metoprolol succinate | 200 o.d.^ | MERIT-HF (metoprolol succinate) |
| Nebivolol | 10 o.d.^ | SENIORS (nebivolol) |
| MRA*: | ||
| Spironolactone | 25–50 o.d.^ | RALES (spironolactone) |
| Eplerenone | 50 o.d.^ | EMPHASIS-HF, EPHESUS (eplerenone) |
| H-ISDN | 40 mg/75 mg t.i.d^ | V-HeFT-I, V-HeFT-II, A-HeFT (hydralazine and isosorbide dinitrate) |
| Diuretics# | The effects of diuretics on mortality and morbidity were not studied in HF | |
| Loop diuretics: | ||
| Furosemide | 40–240 usually o.d. or b.i.d.$ | |
| Torasemide | 10–20 usually o.d.$ | |
| Bumetanide | 1–5 usually o.d.$ | |
| Thiazides: | ||
| Hydrochlorothiazide | 12.5–100 o.d.$ | |
| Indapamide | 2.5–5.0 o.d.$ | |
| Ivabradine | 7.5 b.i.d.^ | SHIFT, BEAUTIFUL (ivabradine) |
| Digoxin | 100–500 µg o.d.$ | DIG (digoxin) |
*
Disease-modifying drugs
#
Recommended for patients with signs and symptoms of congestion irrespective of ejection fraction
^
Target dose
$
Usual dose, ACE inhibitor – angiotensin-converting enzyme inhibitor, ARB – angiotensin receptor blocker, MRA – mineralocorticoid receptor antagonist, H-ISDN – hydralazine and isosorbide dinitrate