Visión multidisciplinar del control de HTA
23/11/16 18:30h Casa del Corazón, Madrid
http://controlhta.secardiologia.es
#controlHTA
Paciente con insuficiencia cardiaca y HTA
Dr. Domingo Marzal Martín, Complejo Hospitalario de Mérida (Badajoz)
@domingomarzal
14. Ponikowski P, et al. Eur Heart J. 2016;37:2129-200
Therapeutic algorithm HFrEF
symptomatic (NYHA Class II-IV)
15. Ponikowski P, et al. Eur Heart J. 2016;37:2129-200
ACE inhibitors
Study Drug Symptoms Results (RRR)
CONSENSUS
N Engl J Med. 1987;316:1429-35
Enalaprilo Severe Mortality 27%
SOLVD
N Engl J Med. 1991;325(5):293-302
Enalaprilo Mild-
moderate
Mortality 16%
Hospitalization 26%
SOLVD Prevention
Trial
N Engl J Med. 1992;327:685-91
Captoprilo
Asymptomatic
post-MI
Mortality/
HF hospitalization 20%
SAVE
N Engl J Med. 1992;327:669-77
Captoprilo
Mortality 26%
Mortality/
HF hospitalization 27%
AIRE
Lancet. 1993;342:821-8
Ramiprilo
TRACE
N Engl J Med. 1995;333:1670-6
Trandolaprilo
16. Ponikowski P, et al. Eur Heart J. 2016;37:2129-200
Beta-blockers
Study Drug Symptoms Results
(RRR – first year treatment)
CIBIS II
Lancet. 1999;353:9-13
Bisoprolol
Mild-
moderate Mortality 34%
HF hospitalization 28-36%
MERIT-HF
Lancet. 1999;353:2001-7
Metoprolol CR/XL
COPERNICUS
Circulation. 2002;106:2194-9
Carvedilol
Severe
>90% patients under treated with ACEI or ARB