Effect of Vasodilator Therapy on Mortality in Chronic Congestive Heart Failure
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Effect of Vasodilator Therapy on Mortality in Chronic Congestive Heart Failure Results of a Veterans Administration Cooperative Study (V-HEFT I). Multicenter, randomized, double-blind, placebo-controlled trial 642 men followed for an average of 2.3 years Patient History:

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Effect of Vasodilator Therapy on Mortality in Chronic Congestive Heart FailureResults of a Veterans Administration Cooperative Study (V-HEFT I)

  • Multicenter, randomized, double-blind, placebo-controlled trial

  • 642 men followed for an average of 2.3 years

  • Patient History:

    • Men with impaired cardiac function and reduced exercise tolerance

    • All patients were taking digoxin and diuretics

  • In addition to mortality, the follow-up data included EF, exercise tolerance and echocardiography

N Engl J Med 1986;314:1547-52


V heft i objectives
V-HEFT I Congestive Heart FailureObjectives

  • To evaluate the effects of vasodilator therapy on mortality among patients with chronic congestive heart failure, impaired cardiac function and reduced exercise tolerance who were taking digoxin and diuretics

  • Patients were randomized to double-blind treatment with placebo, prazosin (20 mg per day), or the combination of hydralazine (300 mg per day) and isosorbide dinitrate (160 mg per day)

N Engl J Med 1986;314:1547-52


V heft i cumulative mortality from the time of randomization in the three treatment groups
V-HEFT I Congestive Heart FailureCumulative Mortality from the Time of Randomization in the Three Treatment Groups

N Engl J Med 1986;314:1547-52


V heft i results
V-HEFT I Congestive Heart FailureResults

  • Mortality over the entire follow-up period was lower in the Hyd-Iso group vs. placebo. The difference was of borderline statistical significance

  • Risk reduction at two years in the Hyd-Iso group was 34% (p=0.028)

  • Risk reduction at three years in the Hyd-Iso group was 36%

  • Mortality in the prazosin group was similar to placebo

  • EF rose significantly at eight weeks and at one year in the Hyd-Iso group but not in the placebo or prazosin groups.

N Engl J Med 1986;314:1547-52


V heft i conclusion
V-HEFT I Congestive Heart FailureConclusion

  • “The data suggests that the addition of hydralazine and isosorbide nitrate to the therapeutic regimen of digoxin and diuretics in patients with chronic congestive heart failure can have a favorable effect on left ventricular function and mortality”

N Engl J Med 1986;314:1547-52


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