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Episode 233: A passing podcast for the failing heart – PART II

In episode 233, Mike and James continue on with how to deal with a failing heart. We talk about nitrates, digoxin and the aldosterone antagonists. We then talk about the approach to using these medications and how we don’t need to get to everybody to high doses of every drug and in fact that this causes considerable harm unless it is done carefully.

Show notes

1) Nitrates

NEJM 2004;351:2049-57

2) DIG trial

NEJM 1997; 336:525-33

3) Aldosterone antagonists

Tools For Practice

Aldosterone antagonists in systolic heart failure – no longer an afterthought

4) Target dose evidence

Network – ACE doses

Eur Heart J 1998;19:481-9

ATLAS – ACE doses

Circ 1999;100:2312-8

Carvedilol doses

Circulation 1996;94:2807-16

Beta-blocker doses

Ann Intern Med 2009;150:784-94

Getting to carvedilol doses

QJM 2004;97:133-9

HEAAL – losartan

Lancet 2009;374;1840-8

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