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They are used in many applications to protect loads, machinery or people from dangerous situations (elevators, compressors, pumps, air conditioning systems, mixing tanks).

Process signals can also be monitored (4-20mA, 0-10V) for machinery operation verification.

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Follow-up averaged 2.3 years (range, 6 months to 5.7 years).

Mortality over the entire follow-up period was lower in the group that received hydralazine and isosorbide dinitrate than in the placebo group.

For mortality by two years, a major end point specified in the protocol, the risk reduction among patients treated with both hydralazine and isosorbide dinitrate was 34 percent (P.

Symptoms and exercise tolerance have been the major therapeutic end points of most previous trials, but the effect of vasodilator drugs on mortality has not been adequately examined.

In 1980, a Veterans Administration Cooperative Study was initiated to determine whether two widely employed vasodilator regimens could alter life expectancy.

In a double-blind trial, men with stable chronic congestive heart failure undergoing conventional treatment with digoxin and diuretics were assigned randomly to receive additional treatment with prazosin, both hydralazine and isosorbide dinitrate, or placebo.

The concept to be tested was that peripheral vasoconstriction not only contributes to hemodynamic derangement and symptoms in heart failure but also may contribute to progressive deterioration of left ventricular function and premature death.

A total of 642 patients were entered into the trial, and all were followed for at least six months until the end of the follow-up period (December 15, 1985).

In addition to information on mortality, the follow-up data consisted of a variety of sequential measurements, including radionuclide ejection fraction, quantitative exercise tolerance, echocardiography, Holter monitoring, and global assessment of functional status.

This report emphasizes the analysis of mortality, the primary end point.

Methods Patients with chronic congestive heart failure were recruited in 11 participating Veterans Administration hospitals.

Recruitment was limited to men between the ages of 18 and 75.

Eligibility for the trial was based on evidence of cardiac dilatation (cardiothoracic ratio 0.55 on chest x-ray film or a left ventricular internal diameter in diastole 2.7 cm per square meter on echocardiography) or left ventricular functional impairment (radionuclide ejection fraction 0.7 ng per milliliter) and to optimize the fluid balance.

Clinical evaluations and exercise-tolerance tests on two consecutive visits (separated by two weeks) had to reveal clinical and exercise stability before randomization could take place.

The patients enrolled in the study continued to receive the optimal dose of digoxin and diuretic and also received one of three study regimens in double-blind fashion.

One group was given placebo tablets and placebo capsules that were to be taken four times daily.

A second group took 2.5-mg prazosin capsules and placebo tablets four times daily.

The third group was given 37.5 mg of hydralazine in matching capsules and 20 mg of isosorbide dinitrate in matching tablets that were to be taken four times daily.

In all groups, therapy began with one capsule and one tablet four times daily.

In the absence of side effects, this dose was increased two weeks later to two capsules and two tablets four times daily.

If side effects that were thought to be drug-related occurred, the dose could be reduced to half a tablet four times daily or to one capsule twice daily.

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