Vasodilator therapy without converting-enzyme inhibition in congestive heart failure--usefulness and limitations

Cardiovascular Drugs and Therapy
W J Remme


Despite a well-established rationale for pharmacologically induced arterial and venous vasodilatation in congestive heart failure, the clinical usefulness of long-term vasodilator therapy without concomitant converting-enzyme inhibition generally has been disappointing. With the exception of nitrates and, possibly, the combination of nitrates and hydralazine, the use of converting-enzyme inhibitors in many aspects appears preferable in the majority of patients. This article reviews the pathophysiology of inappropriate vasoconstriction in heart failure, the cellular mode of action of the various vasodilators, hemodynamic effects with respect to the peripheral site of action, clinical usefulness and limitations of different vasodilators, and the various determinants of clinical efficacy. Finally, an attempt is made to assess when and how to introduce vasodilator treatment with and without concomitant ACE inhibition.


Jan 1, 1991·British Journal of Clinical Pharmacology·R J MacFadyenJ L Reid
Dec 1, 1996·Journal of Cardiac Failure·W J Remme
Mar 15, 1989·The American Journal of Cardiology·W J RemmeC J Storm
Mar 1, 1992·Transactions of the Royal Society of Tropical Medicine and Hygiene·G Webbe


Feb 1, 1978·The American Journal of Cardiology·J A Thomas, B H Marks
Aug 4, 1978·JAMA : the Journal of the American Medical Association·J A FranciosaJ N Cohn
Aug 1, 1979·The American Journal of Cardiology·D H FitchettJ F Goodwin
Sep 1, 1979·Annals of Internal Medicine·S B ArnoldK Chatterjee
Nov 1, 1979·The American Journal of Cardiology·C E DeschC V Leier
Aug 1, 1978·Circulation·B GreenbergK Chatterjee
Dec 21, 1978·The New England Journal of Medicine·J R BenottiA A Alousi
Dec 1, 1976·Circulation·K ChatterjeeA Norman
Jun 1, 1985·Circulation Research·E L SchiffrinJ Genest
Mar 1, 1987·Circulation Research·J A Bevan, J E Brayden
Jan 1, 1987·Journal of Cardiovascular Pharmacology·J P ChalmersP Schuster
Aug 1, 1985·Circulation·L I Goldberg, S I Rajfer
Dec 3, 1985·European Journal of Pharmacology·E H OhlsteinB A Berkowitz
Feb 1, 1986·The Journal of Pharmacy and Pharmacology·S NakamuraS I Rajfer
Sep 1, 1986·The American Journal of the Medical Sciences·C V LeierD V Unverferth
Mar 1, 1987·Journal of the American College of Cardiology·J N BarjonJ De Champlain
Aug 28, 1986·The New England Journal of Medicine·A E RaineF R Bühler
Aug 14, 1987·The American Journal of Cardiology·G ZipperleF Heinrich
Jul 14, 1988·The New England Journal of Medicine·M A PfefferE Braunwald
Jan 1, 1985·Journal of the American College of Cardiology·J A FranciosaR A Jordan
May 1, 1985·International Journal of Cardiology·P C KirlinB Pitt

Related Concepts

Vasodilator [EPC]
Enzyme Inhibitor Drugs
Pathologic Vasoconstriction
Vasodilator Agents
Vasoactive Antagonists
Metabolic Inhibition
Enzyme Inhibition

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