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- Title
Mini review: The clinical avenues of combined hydralazine-nitrate in subjects with heart failure with reduced ejection fraction.
- Authors
Elnour, Asim Ahmed; Sadeq, Adel; Ramadan, Azza; AlAmoodi, Abdulla; Alkwarit, Alin; Alshammari, Asma Faisal; EL Khidir, Israa Yousif; Alrashidi, Nouf Eid; kouhgard, Parisa; Qahtani, Mariam Mohamed Al; Beshir, Semira Abdi; Al-Kubaisi, Khalid Awad; Al Mazrouei, Nadia; Alkaabi, Maisoun; Ashoor, Afaf
- Abstract
Background: Combined hydralazine-nitrate has an avenue in the management of subjects with heart failure with reduced ejection fraction. Exploring the pharmacotherapy in this context will facilitate the clinical utility of the combined therapy. Objective: The main objective of this mini-review was to evaluate the role of combined hydralazine-nitrate in subjects with heart failure with reduced ejection fraction. Methods: We conducted a literature search on Google scholar, MEDLINE, and PubMed to identify the randomized clinical trials on combined hydralazine-nitrate, in subjects with heart failure with reduced ejection fraction. 2760 articles were returned initially out of which 10 trials were conforming to the inclusion criteria. However, three trails were the focus for the current mini-review. Key findings: The current mini-review lends support to the use of combined hydralazine-nitrate in subjects with heart failure with reduced ejection fraction (HFrEF). The combination may offer subjects who have remained symptomatic with HFrEF despite optimum dosing of standard therapy. Black subjects with HFrEF have proved to benefit from combined hydralazine-nitrate. The combination (e.g. small dose of hydralazine 12.5-25 mg twice a day and isosorbide mononitrate 10 mg twice a day) may provide alternative clinical utility in subjects with contraindications (renal artery stenosis, creatinine clearance less than 30 mL/minute, sustained hyperkalemia) to the use of ACEinh, ARBs, and/or ARNI. Subjects with HFrEF on combined hydralazine-nitrate should be assessed and monitored for systolic BP (keep >120 mmHg) and subjects with chronic kidney disease (keep eGFR > 30 mL/min/1.73 m2). Hydralazine-nitrate was inferior to ACEinh (higher all-cause mortality and cardiovascular mortality. Conclusion: The current minireview provides the key points to support the use of hydralazine-nitrate in subjects with heart failure with reduced ejection fraction.
- Subjects
ONLINE information services; DIURETICS; HYDRALAZINE; COMBINATION drug therapy; VENTRICULAR ejection fraction; SYSTEMATIC reviews; NITRATES; MEDLINE; HEART failure; THERAPEUTICS
- Publication
Pharmacy Practice (1886-3655), 2023, Vol 21, Issue 2, p1
- ISSN
1885-642X
- Publication type
Article
- DOI
10.18549/PharmPract.2023.2.2824