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Tuesday, 9 November, 1999, 01:02 GMT
Heart drug offers hope to millions
Heart patient
High drug dose may save heart patients
A drug routinely given to patients with heart failure can significantly reduce the risk of hospitalisation and death if given in higher doses than are commonly used at present, research has found.

More than 10 million people in Europe suffer from heart failure and the majority of these patients will be admitted to hospital or die within the next five years.

The outlook is worse than for breast or prostate cancer sufferers.

In the UK, the current annual cost of heart failure to the NHS has been estimated to be close to 1bn.

But a study of the impact of the drug Lisinopril, also known as Zestril, has shown it can offer many patients new hope - if given in high doses.

Lisinopril, an ACE inhibitor, is commonly given to heart failure patients already, but in relatively low doses.

The Atlas (Assessment of Treatment with Lisinopril and Survival) study found the drug is much more effective if the dose is increased.

Patients are commonly given up to five milligrams of the drug. The Atlas study tested the impact of doses up to 35mg.

'Patients under-treated'

Dr Milton Packer, chairman of the Atlas steering committee, said: "When ACE inhibitors are used, they are usually used in lower doses than were shown to be beneficial in clinical studies.

"Atlas tells us that patients on low dose therapy may be under-treated and can benefit from a higher dose of the same drug, with little increase in side effects."

Dr Packer said if the results of Atlas were translated into clinical practice thousands of lives could be saved each year.

"Physicians who now commonly use low doses of ACE inhibitors will need to rethink their approach to using these valuable drugs," he said

Atlas is the largest study of its kind to evaluate the impact of different doses of an ACE inhibitor on death due to heart failure.

'High doses tolerated'

Results over three to five years from more than 3,000 patients in 19 countries showed that high dose lisinopril reduced the combined risk of death and hospitalisation by 12% compared with low dose.

High doses were well tolerated and most side effects observed were those known to be associated with ACE inhibitors.

About 150,000 heart failure patients are admitted to hospital in the UK each year, rising to 250,000 hospital episodes if repeat hospitalisations are included.

ACE inhibitors, or angiotensin-converting-enzyme inhibitors, are used to reduce high blood pressure, and to treat congestive heart failure in heart-attack patients.

Trials of another ACE inhibitor, ramipril, were stopped six months early in August after the drug was shown to reduce the risk of heart attacks and strokes in patients at risk of cardiovascular disease by between 20 and 30%.

See also:

20 Jul 99 | Health
Heart failure drug breakthrough
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