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In patients with established heart failure (HF), unlike in the general population, low blood pressure is associated with worse prognosis, as it can reflect poor cardiac output. Low BP in HF patients may contribute to clinicians’ reluctance to initiate vasodilator therapy for fear of causing symptomatic hypotension. In a post-hoc analysis from the industry-sponsored, randomized, placebo-controlled trial known as A-HeFT (Journal Watch Cardiology Dec 17 2004), researchers assessed the potential influence of baseline BP and treatment-related BP changes on the efficacy of a fixed-dose combination of isosorbide dinitrate and hydralazine (I/H).
The subjects were 1050 patients, self-identified as African American, with systolic HF and severe, persis…