Which medications benefit patients with diastolic heart failure?
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Angiotensin-converting enzyme inhibitors (ACEIs), propranolol, statins, furosemide, and some angiotensin receptor blockers (ARBs) benefit patients. Medications that reduce mortality in diastolic heart failure include ACEIs (strength of recommendation [SOR]: C, 1 prospective cohort trial with matched controls), propranolol (SOR: B, 1 randomized controlled trial [RCT]), and statins (SOR: C, 1 prospective cohort trial). Furosemide improves symptoms of heart failure and quality of life (SOR: C, 1 RCT, using cohort data). ARBs show mixed results: candesartan decreases hospital admissions (SOR: B, 1 large RCT); losartan improves exercise duration and quality of life (SOR: B, 2 small RCTs); irbesartan doesn't improve heart failure symptoms or other outcomes (SOR: B, 1 large RCT).
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