Perindopril for elderly people with chronic heart failure: the PEP‐CHF study

Cleland, John G.F.; Tendera, Michał; Adamus, J; Freemantle, Nick; Gray, Christopher S.; Lye, Michael; O’Mahony, Denis; Poloński, Lech; Taylor, Jacqueline

doi:10.1016/s1388-9842(99)00039-2

Cited by 243 publications

(185 citation statements)

References 33 publications

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“…The ACEI perindopril, the ARB candesartan, and the β-blocker nebivolol may reduce hospitalizations in older patients with HFpEF. [75][76][77][78][79] In addition, perindopril improved NYHA functional class and exercise tolerance in one study. 76 Digoxin had no effect on either mortality or all-cause readmissions in patients with HFpEF in the DIG ancillary trial.…”

Section: Hf With Preserved Ejection Fractionmentioning

confidence: 97%

“…[75][76][77][78][79] In addition, perindopril improved NYHA functional class and exercise tolerance in one study. 76 Digoxin had no effect on either mortality or all-cause readmissions in patients with HFpEF in the DIG ancillary trial. 80 However, both digoxin (relative risk, 0.88; 95% confidence interval, 0.62-1.25) and candesartan (relative risk, 0.89; 95% confidence interval, 0.77-1.03) have similar effects on reducing hospitalization for worsening HF.…”

Section: Hf With Preserved Ejection Fractionmentioning

confidence: 97%

See 1 more Smart Citation

Heart Failure Management in Skilled Nursing Facilities

Jurgens¹,

Goodlin²,

Dolansky³

et al. 2015

Circ: Heart Failure

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655H eart failure (HF) is a complex syndrome in which structural or functional cardiac abnormalities impair the filling of ventricles or left ventricular ejection of blood. HF disproportionately occurs in those ≥65 years of age.1 Among the estimated 1.5 to 2 million residents in skilled nursing facilities (SNFs) in the United States, cardiovascular disease is the largest diagnostic category, and HF is common. 2,3Despite the high prevalence of HF in SNF residents, none of the large randomized clinical trials of HF therapy included SNF residents, and very few included patients >80 years of age with complex comorbidities.Several issues make it important to address HF care in SNFs. The healthcare environment and characteristics of SNF residents are distinct from those of community-dwelling adults. Comorbid illness unrelated to HF (eg, dementia, hip fracture) increases with age >75 years, and these conditions may complicate both the initial HF diagnosis and ongoing management. [4][5][6] Morbidity and mortality rates are significantly increased for hospitalized older adults with HF discharged to SNFs compared with those discharged to other sites. 7Transitions between hospitals and SNFs may be problematic. 8SNF 30-day rehospitalization rates for HF range from 27% to 43%, 7,9,10 and long-term care residents sent to the emergency department are at increased risk for hospital admission and death.11 The purpose of this scientific statement is to provide guidance for management of HF in SNFs to improve patientcentered outcomes and reduce hospitalizations. This statement addresses unique issues of SNF care and adapts HF guidelines and other recommendations to this setting. MethodsThis scientific statement on HF management in SNFs was developed by a writing group of experts representing nursing, medicine (cardiology, geriatrics, nursing home physicians, and palliative medicine), pharmacology, physical therapy, dietary clinical management, research, and quality of care. Sponsors (the American Heart Association [AHA] and the Heart Failure Society of America) identified specific members of the writing group, and others were selected on the basis of known expertise. A literature search was performed using the key The current document is solely the responsibility of the authors and does not represent the official views of the National Heart, Lung, and Blood Institute or the Department of Health and Human Services.The American Heart Association and the Heart Failure Society of America make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This document was approved by the American Heart Association Science Advisory and Coordinating Committee on September 15, 2014, and by the...

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Section: Hf With Preserved Ejection Fractionmentioning

confidence: 97%

Section: Hf With Preserved Ejection Fractionmentioning

confidence: 97%

Heart Failure Management in Skilled Nursing Facilities

Jurgens¹,

Goodlin²,

Dolansky³

et al. 2015

Circ: Heart Failure

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show abstract

“…The prevalence of arterial hypertension in HFpEF patients amounts approximately 60-88% [1,[86][87][88][89]. The risk of developing HF after adjusting for age and other risk factors is approximately 2-fold higher in hypertensive men and 3-fold higher in hypertensive women than in normotensive persons [90].…”

Section: Hypertensionmentioning

confidence: 99%

“…Aldosterone produces a number of potentially deleterious effects in HFpEF, including sodium and water reabsorption, sympathetic nervous system activation, vasoconstriction, increased oxidative stress with inflammation, remodeling, fibrosis and endothelial dysfunction [103,182]. Targeting the RAAS with ARBs, ACE inhibitors and aldosterone antagonists has long been considered reasonable for HFpEF based on its link to hypertension, fibrosis and fluid imbalance, but despite their clear success in HFrEF, clinical trials with RAAS inhibitors in HFpEF produced neutral outcome results [25,26,87,88,183]. …”

Section: Modulation Of Renin-angiotensin-aldosterone System (Raas)mentioning

confidence: 99%

Impact of Comorbidities on Myocardial Remodeling and Dysfunction In Heart Failure with Preserved Ejection Fraction

Heerebeek

Paulus²

2014

SOJPPS

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“…The PEP-CHF (Perindopril in Elderly People with Chronic Heart Failure) study 15 was a randomized, double-blind, international, multicenter trial that compared perindopril (target dosage, 4 mg/d) to placebo in patients 70 years of age or older who had evidence of clinical HF with relatively preserved EF (≥40%) and echocardiographic evidence of diastolic dysfunction. The study randomized 850 patients, and the mean follow-up was 26 months.…”

Section: Raas Inhibitionmentioning

confidence: 99%