The website domain reflects its role for my own purpose only. Viewing of the webpages by others is not approved.
Main Index Site Developments
Patient Information Conditions of Use



---
Congestive Heart Failure
Due to Systolic Dysfunction

Benefits of maximal dosages of ace-inhibitor therapy

The ATLAS study randomised patients with heart failure and ejection fraction less then 30% to low or high dose of lisinopril.

During the study all cause mortality in the low dose group was 45% and high dose group was 43% (difference not significant).

However, there was a significant reduction in the combined endpoint of hospitalisation or death in the high dose lisinopril group (83.9% to 79.8%, p=0.002).

A few other similar studies have now also been published showing maximal doses of ace-inhibitors provide greater benefits compared to lower doses

However, in some patients with poor LV function and low blood pressures, one might not be able to use maximal doses of ace-inhibitors and betablockers. In these patients we might accept moderate dose ace-inhibitor therapy if this enables us to also use a betablocker.

Hitesh Patel, Cardiologist
6th June, 2004

Reference:
Comparative Effects of Low and High Doses of the Angiotensin-Converting Enzyme Inhibitor, Lisinopril, on Morbidity and Mortality in Chronic Heart Failure. Circulation. 1999;100:rt1-rt7.)
Users should read this document on "copyright" and "conditions of use".