Improved understanding of the pathophysiologic course of heart failure has led to many advances in pharmacologic therapy. Angiotensin-converting enzyme inhibitors represent the first effort at targeting neurohormonal activation in chronic heart failure. More. recently, p-adrenergic receptor antagonists have been shown effective in blocking chronic sympathetic nervous system activation. The roles of digoxln and the newer, vasoselective calcium channel blockers in heart failure have been better defined. Other agents targeting the neurohormonal system are under investigation. These include angiotensinreceptor antagonists, aidosterone inhibitors, and endothelin antagonists, Experience with phosphodiesterase inhibitors and adrenergic agents has confirmed the importance of neurohormonal activation in progression of heart failure. Despite angiotensin-converting enzyme inhibitor, diuretic, and digoxin therapy, mortality in heart failure remains high. Careful manipulation of the neurohormonal response to heart failure holds promise for altering the course of the disease
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Heart Failure| May 01 1998
Innovations in the Pharmacologic Management of Heart Failure
Katherine A. Michael, PharmD, BCPS;
*From the Department of Pharmacy Services, University of Virginia Health System, Charlottesville, Virginia, North Carolina.
Reprint requests to Katherine A. Michael, PharmD, BCPS, Clinical Pharmacy Specialist, Heart Center, University of Virginia Health System, Department of Pharmacy Services, P. O. Box 10002, University of Virginia, Charlottesville, VA 22906-0002.
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AACN Adv Crit Care (1998) 9 (2): 172–191.
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Katherine A. Michael, Kimberly J. Parnell; Innovations in the Pharmacologic Management of Heart Failure. AACN Adv Crit Care 1 May 1998; 9 (2): 172–191. doi:
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