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Cardiovascular diseaseThere are hidden threats, but fortunately, we have a variety of cardiovascular drugs as powerful "weapons". These drugs have their own characteristics and can reduce blood pressure, improveHeart failurePrognosis and other aspects have shown excellent results, bringing new hope to patients.Indications, mechanism of action and side effects are crucial to both patients and medical workers.

Hello everyone, I am Huaizhang Pharmacist. Today I have summarized 9 drugs that can improve the prognosis of heart failure.

1. Sacubitril/Valsartan

This product, through the combined action of its ingredients sacubitril and valsartan, inhibits enkephalinase and blocks the type 1 receptor of angiotensin II, increasing the levels of peptides such as natriuretic peptides and inhibiting the effects of angiotensin II, exerting cardiovascular and renal protective effects in patients with heart failure.

Application: ForEjection fractionIt is used to reduce the risk of cardiovascular death and heart failure hospitalization in adult patients with chronic heart failure (NYHA II-IV, LVEF ≤ 40%). It can replace angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor antagonists (ARB) and be used in combination with other heart failure treatment drugs.hypertension。

Side effects: cough, dizziness, hypotension, angioedema, rash, itching, hyperkalemia, etc.

2. Fosinopril Sodium

This product is converted into pharmacologically active fosinoprilat in the body, which can inhibit angiotensin converting enzyme, reduce the concentration of angiotensin II and aldosterone, dilate peripheral blood vessels, reduce vascular resistance, and produce a hypotensive effect.

Uses: Suitable for the treatment of hypertension and heart failure. When treating hypertension, it can be used alone as the initial treatment drug, or used in combination with other antihypertensive drugs. When treating heart failure, it can be used in combination with diuretics.

Side effects: fatigue, dyspnea, headache, rash, abdominal pain, muscle cramps, angina,Edemaand insomnia,Serum potassiumIncrease.

Other drugs of this type that can improve the prognosis of heart failure include: captopril, enalapril, lisinopril, perindopril, ramipril, benazepril, etc.

3. Candesartan cilexetil

This product is rapidly hydrolyzed into active metabolite candesartan in the body. Candesartan antagonizes the vasoconstriction of angiotensin II by binding to vascular smooth muscle AT1 receptors, thereby reducing peripheral vascular resistance. It can also exert a certain antihypertensive effect by inhibiting the secretion of aldosterone by the adrenal glands. It can reduce systolic and diastolic blood pressure, left ventricular myocardial weight, and peripheral vascular resistance.

Uses: Essential hypertension.

Side effects: angioedema, abnormal liver function, hyperkalemia, muscle pain, weakness, etc.

Other drugs of this type that can improve the prognosis of heart failure include valsartan, losartan, etc.

4. Dapagliflozin

Sodium-glucose cotransporter 2 (SGLT2) is expressed in the proximal renal tubules and is the major transporter responsible for glucose reabsorption after tubular filtration.

Dapagliflozin is a SGLT2 inhibitor that inhibits SGLT2 and reduces the reabsorption of filtered glucose, thereby promoting urinary glucose excretion.Dapagliflozin also reduces sodium reabsorption and increases sodium delivery to the distal tubule. This may affect certain physiological functions, including but not limited to reducing cardiac preload and afterload, downregulating sympathetic nerve activity, and reducing intraglomerular pressure (possibly mediated by increased tubuloglomerular feedback).

Uses: Adults with type 2 diabetes, heart failure, and chronic kidney disease.

Side effects: urinary tract infection, hypovolemia, ketoacidosis, hypoglycemia, rash, etc.

Other drugs of this type that can improve the prognosis of heart failure include empagliflozin and sopagliflozin.

5. Metoprolol

This product is a selective β1 receptor blocker, which blocks the physiological effect caused by adrenaline acting on β1 receptors by binding to β1 subtype receptors, thereby slowing down the heart rate and lowering blood pressure. It can also slow down the resting and exercise heart rate, cardiac output, reduce cardiac work, and reduce myocardial oxygen consumption, thus playing an important anti-ischemic role.

Uses: used for hypertension; also used for exertional angina pectoris,Myocardial infarctionAfter, rapid arrhythmia and heart failure, etc.

Side effects: bradycardia, dizziness, headache, fatigue, cold extremities, palpitations, abdominal pain, nausea,Vomit, constipation, etc.

Other drugs of this type that can improve the prognosis of heart failure include bisoprolol, carvedilol, etc.

6. Spironolactone

This product and its active metabolites are specific antagonists of aldosterone, and they mainly act by competitively binding to the receptors at the aldosterone-dependent sodium-potassium exchange site in the distal renal tubules. Spironolactone can increase the excretion of sodium and water, and has a potassium-sparing effect.

Uses: Prevention of edematous diseases, hypertension, primary aldosteronism, and hypokalemia.

Side effects: hyperuricemia, dysglycemia, gynecomastia, electrolyte imbalance, etc.

7. Eplerenone

This product can selectively act on aldosterone receptors and have an effect on mineralocorticoidshormoneThe receptors are highly selective, but the effect on androgen and progesterone receptors is relatively small. The affinity for mineralocorticoids is 15 to 20 times that of spironolactone, while the affinity for androgen and progesterone receptors is 500 times smaller than that of spironolactone.

Uses: Heart failure and hypertension after myocardial infarction.

Side effects: headache, dizziness, increased glutamyl transpeptidase, angioedema, rash, abnormal breast development in men, etc.

8. Ivabradine

This product is a drug that simply lowers heart rate. It lowers heart rate by selectively and specifically inhibiting the cardiac pacemaker If current (If current controls spontaneous diastolic depolarization in the sinoatrial node and regulates heart rate). Ivabradine only acts specifically on the sinoatrial node, and has no significant effect on atrial, atrioventricular or ventricular conduction time, myocardial contractility or ventricular repolarization.

Use: Suitable for patients with NYHA class II to IV chronic heart failure with sinus rhythm and heart rate ≥ 75 beats/minute and accompanied by cardiac systolic dysfunction.

Side effects: headache, dizziness, flashes of light, blurred vision, bradycardia, poor blood pressure control, etc.

9. Viriciguat

This product is a soluble guanylate cyclase (sGC) stimulator, sGC is an important enzyme in the nitric oxide (NO) signaling pathway. When NO binds to sGC, sGC catalyzes the synthesis of intracellular cyclic guanosine monophosphate (cGMP), which is a second messenger that regulates vascular tone, myocardial contractility, and cardiac remodeling.

Heart failure is associated with impaired NO synthesis and reduced sGC activity, which can lead to myocardial and vascular dysfunction. Vericipirat can increase intracellular cGMP levels by directly stimulating sGC (independent of NO or synergistic with NO), thereby relaxing smooth muscle and dilating blood vessels.

Use: It is indicated for adult patients with symptomatic chronic heart failure with reduced ejection fraction (ejection fraction < 45%) whose condition has stabilized after recent decompensated heart failure and who have been treated with intravenous therapy, to reduce the risk of hospitalization for heart failure or the need for emergency intravenous diuretic treatment.

Side effects: anemia, dizziness, headache, hypotension, nausea, vomiting, indigestion, etc. Pharmaceutical science, for reference only