Abstract
In 1986, researchers demonstrated that hydralazine plus isosorbide dinitrate improved left ventricular function and reduced mortality in patients with chronic congestive heart failure, presumably by reducing both preload and afterload (N Engl J Med 1986; 314:1547). Soon thereafter, use of this combination waned when the same group found the angiotensin-converting-enzyme (ACE) inhibitor enalapril to be superior in a similar population (Journal Watch Aug 6 1991). A decade later, in a retrospective analysis of several heart failure trials, investigators found …
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