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COPYRIGHT 2004 International Medical News Group
NEW ORLEANS -- Treating patients with advanced heart failure with the combination of isosorbide dinitrate and hydralazine in addition to standard therapy led to clinical improvement and a drop in deaths during an average of just 10 months of treatment.
But the medical importance of this report, made at the annual scientific sessions of the American Heart Association, was nearly overshadowed by the issues raised by the study's design, which tested the drug combination exclusively in patients who self-identified themselves as being of African descent.
The design prompted the obvious question of whether similar benefits from isosorbide dinitrate and hydralazine would be gained by heart failure patients from other racial groups.
Several experts who commented at the meeting maintained that the answer was clearly yes, and that they wouldn't hesitate to prescribe this drug combination to all patients with advanced heart failure once the fixed-dose combination was available in the United States, probably by sometime next year.
A related issue was why the study had been limited to African Americans. Organizers of the African-American Heart Failure Trial (A-HeFT) defended the design based on results from past studies, which hinted that the effects of isosorbide dinitrate and hydralazine were strongest in African Americans, and the failure of many past studies to prove the value of cardiovascular medications in...
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