Review of Pharmacology - 9E (2015)

Cardiovascular System
Treatment of Compensated/Chronic CHF
Main aim is to decrease the work of heart by decreasing the preload and afterload and to
decrease the mortality by reversing cardiac remodeling. Major drugs used for chronic CHF are
vasodilators, ACE inhibitors, ARBs, beta blockers and aldosterone antagonists.
VASODILATORS
These drugs may act by reducing preload (venodilators), afterload (arteriolar dilators) or both
(combined arteriolar and venodilators). Nitrates preferentially dilate veins therefore benefit
in CHF is due to preload reduction. Hydralazine, minoxidil and calcium channel blockers
like nifedipine are primarily arteriolar dilators and cause afterload reduction. These drugs are
preferred in forward failure with low cardiac index (