The fixed-dose combination of isosorbide dinitrate and hydralazine has a race-specific indication for congestive heart failure in which group?

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

Answer: (A)

In treating heart failure, some therapies have been shown to work better in specific patient groups, guiding race-specific approvals. The fixed-dose combination of isosorbide dinitrate and hydralazine (BiDil) was studied in African American patients and shown to improve survival when added to standard therapy. The two drugs work in tandem to reduce the heart’s workload: isosorbide dinitrate releases nitric oxide to cause venodilation and lower preload, while hydralazine causes arterial dilation to reduce afterload. This combined effect can significantly improve outcomes in the determined population, leading to an approved indication specifically for African American patients with symptomatic heart failure despite optimal therapy. The other racial groups don’t have this race-specific approval, so they aren’t the indicated population for this combination.