Copyright © 2003 by the European Society of Cardiology.
Hotline Editorial
Angiotensin receptor blockers and clinical trials in heart failure
University of Minnesota, Minneapolis, MN, USA
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Growing evidence that angiotensin II contributes to the structural abnormalities of the left ventricle and vasculature that characterize chronic heart failure has made it attractive to study the efficacy of angiotensin AT1-receptor blockade in this syndrome. The problem, however, has been in experimental design. Since most patients should be and are taking ACE inhibitors, and ACE inhibitors are thought to reduce angiotensin II formation, conventional wisdom suggested that angiotensin receptor blockers should be considered as alternatives to ACE inhibitors, not as supplemental therapy.Indeed, the earlier ELITE trial compared the efficacy of the two drug classes with
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