Demographics, Treatment Regimens and the Use of Angiotensin-Receptor Blockers in Heart Failure: Findings from the Valsartan Heart Failure Trial

Abstract

Heart failure is the only major cardiovascular disease with an incidence and prevalence that continue to increase in the developed world. Early identification and correct treatment of the condition are of paramount importance. In recent years, there has been growing interest in identifying the differences between patients in terms of their risk of heart failure and response to treatment. Differences between men and women, different age groups, patients with varying aetiologies or comorbidities and differences between ethnic groups are only some of the factors that have been identified. This review surveys the available data on differences in responses to treatment, and discusses the use of angiotensin-receptor blockers in heart failure in light of the recent Valsartan Heart Failure Trial (Val-HeFT).

The benefits of valsartan in the treatment of heart failure: results from Val-HeFT

“…Valsartan improved outcome in patients with and without pre‐existing diabetes or ischaemic heart disease, with NYHA class II and class III/IV symptoms and in those with LVEF and LVIDd above and below the median (≥27/<27% and ≥3.57/<3.57 cm/m 2 , respectively). It is also noteworthy that the beneficial effects of valsartan were observed irrespective of age (risk reduction for CHF hospitalisation of 29% in patients ≥65 years and 26% in patients <65 years) (28), suggesting that there should be no age bias for the goal of attempting to optimise CHF therapy. Similarly, post hoc analysis of the trial data showed a favourable effect of valsartan vs. placebo on the combined mortality/morbidity endpoint in subgroups of males, females and post‐menopausal females (≥55 years), with risk reductions of 12.8, 16.1 and 17.6%, respectively (29).…”