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Understanding and Managing Chronic Heart Failure

• Angiotensin-converting enzyme (ACE) inhibitors: For people with systolic chronic heart failure, ACE inhibitors are often one of the medications prescribed. These medications are called vasodilators because they widen blood vessels and thus lower blood pressure, decreasing the amount of work the heart has to do. They have proved effective in helping people with systolic chronic heart failure live longer and feel better. • Angiotensin receptor-neprilysin inhibitor (valsartan/sacubitril): This new drug is a combination of an angiotensin II receptor blocker (ARB) and a medicine that inhibits the production of neprilysin, an enzyme that breaks down natural substances in the body that open narrowed arteries. It improves artery opening and blood flow, reduces sodium retention and decreases strain on the heart. They should not be taken by patients who are using angiotensin-converting enzyme (ACE) inhibitors or in patients who have or had angioedema. • Angiotensin II receptor blockers (ARBs): Not everyone can tolerate ACE inhibitors as well as they’d like, and for these people, ARBs—another type of vasodilator—are often prescribed as an alternative. They provide many of the same benefits as ACE inhibitors. • Beta blockers: Another medication that has been proven to help people live longer, beta blockers help slow the heart rate and reduce blood pressure. They can also sometimes reverse some of the damage to your heart caused by systolic chronic heart failure. They can help reduce the risk of abnormal heart rhythms, lessen the symptoms of chronic heart failure and improve heart function, as well. • Digitalis: Also used in cases of systolic chronic heart failure, digitalis (also known as digoxin) strengthens your heart’s muscle contractions and tends to slow the heartbeat. • Diuretics (water pills): These medications cause you to urinate more often, which helps prevent fluid buildup in the body. Your doctor may prescribe mineral supplements along with diuretics, as these medications can reduce the levels of potassium and magnesium in your body. Regular blood tests may be ordered to be sure that your levels of these important minerals are where they should be. • Sinoatrial node modulator (ivabradine): This new drug is used in conjunction with beta blockers when they cannot lower heart rate sufficiently. It helps reduce the amount of oxygen your heart needs and the amount of work your heart has to do to pump blood through the body. 11


Understanding and Managing Chronic Heart Failure
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