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Isosorbide dinitrate plus hydralazine was effective for advanced heart failure in black patients
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 Q In black patients with New York Heart Association (NYHA) class III or IV heart failure (HF) with dilated ventricles, is a fixed dose of isosorbide dinitrate plus hydralazine (ID+H) better than placebo?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Internal medicine ★★★★★☆☆ Cardiology ★★★★★★☆

METHODS

Embedded ImageDesign:

randomised placebo controlled trial (African-American Heart Failure Trial [A-HeFT]).

Embedded ImageAllocation:

concealed.*

Embedded ImageBlinding:

blinded (clinicians, patients, data collectors, outcome assessors, monitoring committee, and statisticians).*

Embedded ImageFollow up period:

18 months.

Embedded ImageSetting:

161 centres in the US.

Embedded ImagePatients:

1050 adults (mean age 57 y, 60% men) self identified as black who had NYHA class III or IV HF for ⩾3 months, had left ventricular dysfunction in the preceding 6 months, and were receiving standard HF therapy. Exclusion criteria included acute MI, stroke, cardiac surgery, or …

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