Developments in Brief : Heart Patients Helped by Drug Combination

Some patients with poorly functioning hearts survive longer if they are prescribed a widely used combination of four drugs, according to a study in the current issue of the New England Journal of Medicine.

The study of 642 men in 11 Veterans Administration hospitals examined therapy of chronic congestive heart failure, a disease with a poor prognosis. In this condition, the heart is unable to pump out all the blood that returns to it, leading to a backup of blood in the veins and the accumulation of fluid in such places as the lungs and legs.

The study showed that use of the four drugs not only made patients feel better and increased their ability to exercise, but also extended some lives.

After two years of treatment, for example, 74.4% of patients receiving the four drugs were alive, compared to 65.7% of patients who received only two of the drugs.

All patients studied received digoxin, a drug that stimulates the heart, and water pills called diuretics, which help the kidneys get rid of excess fluid. These medicines have been standard therapy for congestive heart failure for many years.

The two additional drugs were hydralazine and isosorbide dinitrate, drugs that have become widely used over the last decade. These medicines reduce the strain on a weakened heart by lowering the resistance to the flow of blood in the arteries and veins.