Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Investigation of the efficacy of beta-blockers and renin-angiotensin-aldosterone system inhibitors in chronic heart failure with preserved ejection fraction

Di Zhao¹, Yanling Bu², Jairui Guo¹, Yanping Huo³, Na Zhang⁴, Haifeng Shao¹

¹Department of Cardiology I, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang, China; ²Department of Ultrasonography, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang, China; ³Department of Cardiology II, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang, China; ⁴Heart Failure Center, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang, China.

For correspondence:- Haifeng Shao Email: shaohaifeng28@sina.com Tel:+864522697298

Accepted: 3 January 2024 Published: 30 January 2024

Citation: Zhao D, Bu Y, Guo J, Huo Y, Zhang N, Shao H. Investigation of the efficacy of beta-blockers and renin-angiotensin-aldosterone system inhibitors in chronic heart failure with preserved ejection fraction. Trop J Pharm Res 2024; 23(1):175-182 doi: 10.4314/tjpr.v23i1.22

© 2024 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the clinical effectiveness of beta-blockers (BBs) and renin-angiotensin-aldosterone system (RAAS) inhibitors in chronic heart failure with preserved ejection fraction (HFpEF).

Methods: 100 patients with HFpEF admitted to The Third Affiliated Hospital of Qiqihar Medical University, China, between April and June 2023 were stratified into five groups. Beta-blocker (BB) group received bisoprolol, angiotensin-converting enzyme inhibitor (ACEI) group received benazepril hydrochloride, angiotensin II receptor blocker (ARB) group received candesartan, angiotensin receptor neprilysin inhibitor (ARNI) group received sacubitril valsartan, and mineralocorticoid receptor antagonist (MRA) group received spironolactone. Differences in clinical effectiveness, six-minute walking distance (6MWD), cardiac functionality, quality of life, and survival rate were compared among the groups.

Results: Beta-blocker group showed the highest efficacy. After treatment, all groups except MRA showed significant improvement in 6MWD. Also, ACEI, ARB, and ARNI groups exhibited significantly longer 6 MWD than MRA group (p < 0.05). Left ventricular ejection fraction levels showed significant improvement in the ACEI, ARNI, and MRA groups (p < 0.05), while pulmonary artery pressure (PAP) decreased in the BB, ACEI, ARNI, and MRA groups (p < 0.05). After treatment, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores of BB, ACEI, ARB, and ARNI groups were significantly lower than before treatment (p < 0.05). All five groups significantly exhibited decline in NT-proBNP levels after treatment (p < 0.05). However, at 18-month follow-up, there was no significant difference in survival rates among the groups (p > 0.05).

Conclusion: Beta-blockers (BBs) and RAAS inhibitors show promising activity in HFpEF, bisoprolol enhances cardiac function, benazepril improves symptoms, candesartan aids exercise and sacubitril valsartan elevates cardiac class. However, none of these drugs significantly improves clinical outcomes.

Keywords: Beta-blocker, Renin-Angiotensin-Aldosterone System inhibitor, Heart failure with preserved ejection fraction, Efficacy, Cardiac function