© 2007 European Society of Cardiology
Sex differences in the effectiveness of angiotensin receptor blockers and angiotensin converting enzyme inhibitors in patients with congestive heart failure
E-mail address: marie.hudson{at}megill.ca.
Author's reply to the letter from Drs Strauss and Hall
The debate around the safety of angiotensin receptor blockers post-myocardial infarction has been ongoing for some time and Drs Strauss and Hall have in fact previously published their concerns in this area[1]. Others have had a different interpretation of the available evidence[2]. This illustrates well that even randomized controlled trials have gaps and often raise as many questions as they answer. Clearly, the issue of sex differences in the response to cardiac medications is one such large gap. The trials cited by Drs Strauss and Hall are excellent examples of this in that the majority of patients were men and none was powered to look at efficacy in women alone. Our study was a hypothesis-generating attempt to begin to bridge this gap in women with heart failure. As we explicitly stated in our conclusion, and in complete agreement with Drs Strauss and Hall, the definitive answer to the question whether there are differences in the efficacy of angiotensin receptor blockers and angiotensin converting enzyme inhibitors in women with heart failure will only come through a properly powered trial specifically designed to address that question in that population. We await with great impatience the results of such a trial.
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- Strauss M.H., Hall A.S. Angiotensin receptor blockers may increase risk of myocardial infarction: unraveling the ARB-MI paradox. Circulation (2006) 114(8):838–854.
[Free Full Text] - Tsuyuki R.T., Macdonald M. Angiotensin receptor blockers do not increase risk of myocardial infarction. Circulation (2006) 114(8):855–860.
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