Identifying optimal doses of heart failure medications in men compared with women
| Autor: | Vera Regitz-Zagrosek, Chung-Lieh Hung, Houng Bang Liew, Leong L. Ng, Stefan D. Anker, Dirk J. van Veldhuisen, Lieng H. Ling, Calambur Narasimhan, Jozine M. ter Maaten, Sang Weon Park, Sven Meyer, Kenneth Dickstein, Faiez Zannad, Hans L. Hillege, Nilesh J. Samani, John G.F. Cleland, Shu Zhang, Eugenio B. Reyes, Chim C. Lang, Alice Ravera, Iziah E Sama, Bernadet T. Santema, Wouter Ouwerkerk, Adriaan A. Voors, Inder S. Anand, Arthur Mark Richards, Wataru Shimizu, Marco Metra, Tachapong Ngarmukos, Jasper Tromp, Pim van der Harst, Bambang Budi Siswanto, Carolyn S.P. Lam, Peter van der Meer |
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| Přispěvatelé: | Epidemiology and Data Science, Dermatology, Life Course Epidemiology (LCE), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Restoring Organ Function by Means of Regenerative Medicine (REGENERATE) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Adrenergic beta-Antagonists Angiotensin-Converting Enzyme Inhibitors 030204 cardiovascular system & hematology 03 medical and health sciences Angiotensin Receptor Antagonists 0302 clinical medicine Primary outcome Sex Factors Angiotensin-Converting Enzyme Inhibitors/administration & dosage Aged Female Heart Failure Humans Prospective Studies Stroke Volume Internal medicine medicine In patient 030212 general & internal medicine Prospective cohort study Adrenergic beta-Antagonists/administration & dosage Ejection fraction business.industry General Medicine medicine.disease Heart Failure/drug therapy R1 3. Good health Angiotensin Receptor Antagonists/administration & dosage Heart failure Cohort Stroke Volume/drug effects business Medical therapy Cohort study |
| Zdroj: | Lancet, 394(10205), 1254-1263. Elsevier Limited The Lancet, 394(10205), 1254-1263. ELSEVIER SCIENCE INC |
| ISSN: | 0140-6736 |
| Popis: | BACKGROUND: Guideline-recommended doses of angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), and β blockers are similar for men and women with heart failure with reduced ejection fraction (HFrEF), even though there are known sex differences in pharmacokinetics of these drugs. We hypothesised that there might be sex differences in the optimal dose of ACE inhibitors or ARBs and β blockers in patients with HFrEF.METHODS: We did a post-hoc analysis of BIOSTAT-CHF, a prospective study in 11 European countries of patients with heart failure in whom initiation and up-titration of ACE inhibitors or ARBs and β blockers was encouraged by protocol. We included only patients with left ventricular ejection fraction less than 40%, and excluded those who died within the first 3 months. Primary outcome was a composite of time to all-cause mortality or hospitalisation for heart failure. Findings were validated in ASIAN-HF, an independent cohort of 3539 men and 961 women with HFrEF.FINDINGS: Among 1308 men and 402 women with HFrEF from BIOSTAT-CHF, women were older (74 [12] years vs 70 [12] years, pINTERPRETATION: This study suggests that women with HFrEF might need lower doses of ACE inhibitors or ARBs and β blockers than men, and brings into question what the true optimal medical therapy is for women versus men.FUNDING: European Commission. |
| Databáze: | OpenAIRE |
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