Study identifies new treatment option for heart failure patients

December 05, 2001

MINNEAPOLIS/ST. PAUL--Final results of the Valsartan Heart Failure Trial (Val-HeFT) published in the Dec. 5 New England Journal of Medicine demonstrate that adding the angiotensin II receptor blocker (ARB) valsartan to prescribed therapy for patients with heart failure leads to significant, incremental improvements in symptoms and in outcomes.

Val-HeFT showed that valsartan decreased morbidity from heart failure by a statistically significant 13.2 percent (p=0.009) and reduced hospitalizations for heart failure by 27.5 percent (p<0.001) in patients already taking heart failure therapy prescribed by their physicians. The Val-HeFT clinical trial was sponsored by Novartis Pharma AG, manufacturers of valsartan.

"Val-HeFT identified a critical role for valsartan in the management of heart failure," said Jay N. Cohn, M.D., professor of medicine, cardiovascular division, University of Minnesota Medical School and Val-HeFT lead investigator. "Despite several potent drugs with proven benefits, impaired quality of life and recurring hospitalization are detrimental to both patients and the healthcare system. Val-HeFT shows that valsartan improves outcomes in patients with this devastating disease."

The largest study ever completed in heart failure--and the first completed study to show positive effects on patient outcomes with an ARB--Val-HeFT compared the efficacy of valsartan to placebo in patients who continued to receive all other appropriate heart failure therapy, which included ACE inhibitors, beta blockers, diuretics and digoxin.

A multinational trial of a diverse population of 5,010 patients from 302 centers in 16 countries, Val-HeFT had two primary endpoints: combined mortality and morbidity (including sudden death with resuscitation, hospitalization and administration of IV inotropic or vasodilating agents for heart failure); and all-cause mortality.

The findings of Val-HeFT across cardiovascular endpoints were consistently positive. Besides the 13.2 percent reduction in heart failure morbidity, other findings of Val-HeFT were significant improvements in patients' New York Heart Association (NYHA) classification (p<0.001), indicating favorable effects on disease progression; significant improvements in ejection fraction (p=0.001); and significant improvements in clinical signs and symptoms of heart failure (dyspnea, fatigue, edema and rales) (p=0.01). Valsartan patients also experienced significantly better quality of life (p=0.005) as measured by the Minnesota Living with Heart Failure questionnaire. The rate of all-cause mortality was similar between study arms.

The beneficial effects of valsartan were generally consistent across Val-HeFT patient subgroups regardless of age, gender, or co-existing conditions such as diabetes and coronary artery disease. Valsartan therapy was also generally well tolerated. Adverse events leading to withdrawal occurred in 9.9 percent of patients receiving valsartan and 7.3 percent of patients receiving placebo (P<0.001). The most commonly reported adverse events included dizziness and hypotension. Clinical benefits were not observed in patients who took valsartan in combination with both an ACE inhibitor and beta blocker.

Heart failure develops when the heart is unable to pump blood efficiently because of injury from a heart attack, high blood pressure, damage to the heart muscle (cardiomyopathy), or other causes. Worldwide, the prevalence of heart failure is 20 million and rising dramatically.

In the United States, heart failure currently affects five million Americans, and more than 500,000 new cases are detected each year. Because more people survive heart attacks than ever before, it is expected that more people will develop heart failure. Heart failure is also the major cause of hospitalization in the Medicare population. Costs for treating heart failure are expected to exceed $50 billion this year in the United States. About one million Americans were hospitalized in the last year for heart failure--more than triple the number of patients hospitalized for this condition two decades ago.
Jay N. Cohn, M.D., professor of cardiology, University of Minnesota
Sarah Youngerman, Academic Health Center, 612-624-4604,
Deane Morrison, University News Service, 612-624-2346,

University of Minnesota

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to