Efficacy of isosorbide dinitrate and hydralazine combination in non ischemic dilated cardiomyopathy in a tribal based population at a tertiary care hospital

Non ischemic dilated cardiomyopathy is an important cause of heart failure and cardiovascular mortality. Numerous pharmacologic therapies have been applied from the ancient era for treatment. Some of them have only morbidity benefit. Pauci number has definite mortality benefit. They have diverse mode of action, side effects, cost, drug interaction, tolerance. But here one size does not fit for all. Most of the medicines are costly. More than that they are not equally effective in all groups of patient. This racial difference in efficacy of medicines make it an important cause of treatment failure. From various literatures it was concluded that combination therapy with H-ISDN in addition to conventional medicines are very effective in black population group. In our study we have tried to establish the efficacy of fixed dose drug combination (Hydralazine + Isosorbide dinitrate) to alleviation of heart failure symptoms and mortality benefit if any. Though cheap objective of the study resolved, their remains some unanswered question which may possibly achieve in future to establish the long term benefit.