What is the recommended first-line treatment to decrease afterload in aortic regurgitation?

In the context of aortic regurgitation, the primary goal of treatment is to decrease afterload, which alleviates the volume load on the left ventricle and reduces the backward flow of blood. Dihydropyridine calcium-channel blockers are effective in this regard because they promote vasodilation, which leads to a reduction in systemic vascular resistance. This decrease in afterload allows the heart to pump more efficiently, improving symptoms and overall function in patients with aortic regurgitation.

While beta blockers can help in some cases by reducing heart rate and contractility, they are not the first-line treatment specifically aimed at decreasing afterload. ACE inhibitors also provide benefit in certain heart conditions by lowering afterload and addressing heart failure symptoms, but they are generally not considered first-line for isolated aortic regurgitation management. Diuretics may help with volume overload but do not directly reduce afterload. Therefore, dihydropyridine calcium-channel blockers are the preferred first-line option for directly decreasing afterload in patients with aortic regurgitation.