Drugs in cardiac cachexia

Q: Which of the following drugs can help independently in cardiac cachexia?

A) ACE-I

B) Hydralazine

C) Clonidine

D) Ca-Channel-blockers

E) spironolactone

Answer: A

Angiotensin-converting enzyme inhibitors (ACE inhibitors) can independently be beneficial in reducing cardiac cachexia in patients with chronic heart failure. 

Actually, ACE inhibitors can also be used to reverse frailty and muscle wasting in elderly patients without heart failure! (weak evidence).

Beta-blockers have been described with the same effect. However, all other choices given in the above question have not shown such an independent association.

#pharmacology

#cardiology

#geriatrics

References:

1. Rolfe M, Kamel A, Ahmed MM, Kramer J. Pharmacological management of cardiac cachexia: a review of potential therapy options. Heart Fail Rev. 2019 Sep;24(5):617-623. doi: 10.1007/s10741-019-09784-3. PMID: 30923991.

2. Israili ZH, Hall WD. ACE inhibitors. Differential use in elderly patients with hypertension. Drugs Aging. 1995 Nov;7(5):355-71. doi: 10.2165/00002512-199507050-00004. PMID: 8573991.