Generic drug effectively treats heart failure.

Patients whose hearts are unable to pump blood effectively are only two-thirds as likely to die of heart disease when they add a rarely used generic drug to standard treatments. These findings were so dramatic that researchers halted their study 18 months early and released its results before the scheduled publication in the Sept. 2 NEW ENGLAND JOURNAL OF MEDICINE.

In a worldwide study, researchers gave spironolactone to 822 people with severe heart failure and a placebo to 841 patients. Both groups also received widely accepted drugs. After 2 years, 46 percent of the patients getting placebo--but only 35 percent of those getting spironolactone--had died.

About 10 percent of the men getting spironolactone in the study reported breast pain and swelling, but the drug had few other side effects. Spironolactone blocks the action of aldosterone, a hormone that makes blood vessels stiffer and promotes both salt and water retention, circumstances that make it harder for the heart to beat.

This inexpensive drug "could have a huge impact around the world," says lead researcher Bertram Pitt of the University of Michigan in Ann Arbor. Because of its effectiveness, spironolactone should be widely used, says Karl T. Weber of the University of Missouri Health Sciences Center in Columbia.