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LOSARTAN AS AN ALTERNATIVE TO ACE INHIBITORS FOR CHF.

ACE inhibitors have been shown to improve survival for patients with congestive heart failure (CHF) due to systolic dysfunction, but many patients cannot tolerate these drugs because of side effects.

This double-blind, randomized trial compared losartan (an angiotensin II receptor antagonist) with the ACE inhibitor enalapril in 116 patients with CHF and left ventricular ejection fractions of 45 percent or less. All patients had previously been receiving ACE inhibitors; non-study ACE inhibitors were discontinued at randomization. At 12 weeks, functional capacity (as measured by treadmill exercise time and six-minute walking test), symptoms, and left ventricle ejection fraction were similar with both treatments.

Comment: This study suggests that losartan may well be as beneficial as ACE inhibitors for patients with CHF. Determining whether losartan also leads to improved survival will require longer-term, larger studies.

— TH Lee

Published in Journal Watch General Medicine October 14, 1997

Citation(s):

Lang RM et al. Comparative effects of losartan and enalapril on exercise capacity and clinical status in patients with heart failure. J Am Coll Cardiol 1997 Oct 30 983-991.

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