Two Drugs for Heart Failure Show Mixed Results

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These findings should give doctors more confidence in using this drug even in heart failure patients with extremely low blood pressure, Anand said. "Treating heart failure patients with low blood pressure would be much more beneficial in terms of mortality and morbidity," he said.

One expert agreed that patients with heart failure need to be treated more aggressively.

"Although high blood pressure is one of the most important risk factors for developing heart failure, there is a paradoxical relationship between blood pressure levels and outcomes in patients with established heart failure: the lower the blood pressure, the worse the outcome." said Dr. Gregg C. Fonarow, the Eliot Corday professor of cardiovascular medicine and science and director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles.

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"While these heart failure patients have the greatest need for aggressive therapy, physicians are frequently reluctant to treat these patients with the guideline-recommended heart failure medications -- ACE inhibitors, angiotensin receptor blockers and beta blockers -- out of concern that these medications will further lower blood pressure," Fonarow said.

"This study shows that these concerns are largely unfounded, and heart failure patients with lower blood pressure can be safely and effectively treated with recommended heart failure medications," Fonarow said.

In the second study, the risks and benefits of nesiritide were weighed. The drug has been shown to relieve breathing difficulty due to lung congestion in patients with advanced heart failure. However, the risks associated with the drug are uncertain.

"For some time, we have been intrigued by a new class of drugs that reproduces a natural hormone in the body that appears to do favorable things," said lead researcher Dr. Clyde W. Yancy, from Baylor University Medical Center in Dallas. "We know that the drug nesiritide has some benefit for patients hospitalized with heart failure, but there have been some questions about how safe it is."

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