WINSTON-SALEM, NC -- December 4, 2008 -- Irbesartan does not improve diastolic heart failure, according to a study published in the December 4 issue of the New England Journal of Medicine.
The findings are disappointing to researchers who continue to study other medications in search of a successful treatment for the condition.
"Heart failure is the only cardiovascular disease on the rise," said principal investigator Dalane Kitzman, MD, Department of Internal Medicine, Wake Forest Baptist, Winston-Salem, North Carolina.
"And this newer form of the disease is increasing fastest of all. That's what makes it disconcerting -- that we don't have a proven effective treatment. We sort of have to go back to the drawing board."
For the study, Dr. Kitzman and colleagues recruited 4,128 patients, aged 60 years or older, with diastolic heart failure from 25 countries. The patients were randomly placed into 2 groups. One group received irbesartan (Avapro) 300 mg and the other group was given a placebo. Patients were tracked for 5 years.
Treatment with irbesartan did not reduce the risk of death or hospitalisation for cardiovascular causes among patients who had diastolic heart failure, nor did it improve any of the secondary clinical outcomes, including quality of life.
Researchers chose irbesartan for the study because previous smaller studies in humans with diastolic heart failure indicated that the drug may have had a potential benefit, Dr. Kitzman said.
While irbesartan was not successful in treating diastolic heart failure, the study showed the medication to be safe for patients with the condition.
He also noted that there were fewer negative outcomes than predicted in part because blood pressure was well controlled from the start of the study by design. While the results were not positive, the study does provide helpful clues to treatment of the disease.
"If you have the disease but can control blood pressure with medication, the patient is likely to do pretty well," said Dr. Kitzman.
SOURCE: Wake Forest University Baptist Medical Center
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