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European Journal of Heart Failure 2003 5(5):693-696; doi:10.1016/S1388-9842(03)00055-2
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© 2003 European Society of Cardiology

Determinants of failure to prescribe target doses of angiotensin-converting enzyme inhibitors for heart failure

Juliet Manyemba*, Arduino A. Mangoni, Keith W. Pettingale and Stephen H.D. Jackson

Department of Health Care of the Elderly, Clinical Age Research Unit, Guy's King's and St. Thomas School of Medicine, King's College Hospital London SE5 9PJ, UK

* Corresponding author. Tel.: +44-207-346-3420; fax: +44-207-346-3441. E-mail address: juliet.manyemba@kcl.ac.uk

Received November 26, 2002; Revised February 27, 2003; Accepted April 23, 2003

The first 10% of the full text of this article appears below.


   1. Background
 
Angiotensin-converting enzyme (ACE) inhibitors reduce mortality, frequency of hospitalisation for heart failure and slow the progression of left ventricular systolic dysfunction [1,2]. These benefits are independent of baseline use of diuretics, aspirin and beta-blockers and of the type of ACE inhibitor prescribed. Since the original descriptions of outcome benefit from ACE inhibitors, attention has been focussed on examining the dose–response relationship.

The ATLAS study demonstrated reduction in the combined endpoint of mortality and hospitalisation (hazard ratio 0.85, 95% CI 0.78–0.93) with lisinopril 32.5–35 mg daily vs. 2.5–5 mg daily but there is no significant benefit in all-cause mortality and cardiovascular mortality [3]. The NETWORK trial, conducted by general practitioners and hospital physicians in the UK, compared low dose enalapril (5 mg) with intermediate dose (10 mg) and high dose (20 mg) in patients . . . [Full Text of this Article]


   2. Aim
 

   3. Methods
 

   4. Results
 

   5. Discussion
 

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