The fixed-dose combination of isosorbide dinitrate and hydralazine is specifically indicated for which patient group with congestive heart failure?

• A. African Americans
• B. Caucasians
• C. Asians
• D. Hispanics

Answer: (A)

Isosorbide dinitrate/hydralazine is indicated for African American patients with heart failure because trial data showed a mortality benefit when added to standard therapy in that population. Hydralazine lowers afterload by dilating arteries, while isosorbide dinitrate reduces preload by venodilation; together they improve cardiac output and symptoms. In the African-American Heart Failure Trial, patients with advanced heart failure on optimal therapy who received this combination lived longer than those on standard therapy alone. The benefit was specifically demonstrated in African American patients, so the indication targets that group. The same level of proven mortality benefit has not been shown in other racial groups, which is why the labeling emphasizes African American patients.