Heart Failure Stage A Patients: Who Should Consider Adding an Angiotensin-Converting Enzyme Inhibitor?
Angiotensin-converting enzyme inhibitors are a class of drugs often utilized in cardiovascular and renal disease cases. They can reduce systolic wall stress, preload, and afterload (Herman et al., 2023). It is often used as the first-choice therapy for patients with heart failure.
However, it is vital to consider specific effects that may cause complications if additional conditions are present. ACE inhibitors may cause severe decreases in blood pressure post-exercise hypertension that lead to a similar reduction. As such, patients partaking in physical exercise must adhere to a cooldown of ten minutes in order to minimize chances of dropping blood pressure or even blood pooling in skeletal muscles.
Introducing Diuretics: When Are They Typically Added in the Progression of Heart Disease?
Diuretics, often called water pills, provide a patient with the ability to pass more urine and reduce ankle swelling, and breathlessness that occurs due to heart failure. While a variety of diuretics exist, heart failure treatments usually include bumetanide and furosemide. However, sodium and potassium may be reduced in the patient’s blood, and dehydration may be present.
Diuretics are prescribed to patients only if symptoms persist after the use of ACE inhibitors and beta-blockers. Essentially, they can be prescribed in earlier stages in order to manage symptoms. They are especially effective in affecting hypertension and fluid congestion. Continued symptoms may lead to further prescriptions of more severe medication.
Heart Failure and Diuretics: Are All Patients at Stage A Eligible?
Stage A provides that the risk of having heart failure is incredibly high, but the patient is not yet experiencing the condition. This is usually noted through risk factors such as high blood pressure, high cholesterol, diabetes, obesity, a poor diet, excessive alcohol consumption, and a sedentary lifestyle. In the case that the patient is experiencing difficulties with fluid congestion, hypertension, and high blood pressure, they will be able to use diuretics. They would likely have first attempted to treat the symptoms with ACE inhibitors and beta-blockers.
Reference
Herman, L. L., Padala, S. A., Ahmed, I, & Bashir, K. (2023). Angiotensin converting enzyme inhibitors (ACEI). National Library of Medicine. Web.