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December 7, 1999Circulation

High doses of lisinopril led to 12% lower risk of death or hospitalization and 24% fewer heart failure hospitalizations compared to low doses.

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Why the study?

Does high-dose lisinopril reduce morbidity and mortality compared to low-dose lisinopril in patients with chronic heart failure?

Population

Patients with New York Heart Association class II to IV heart failure and an ejection fraction ≤30%

Comparison

High doses of lisinopril added to background… vs Low doses of lisinopril added to background…

Design

RCT, Randomly assigned, Double-blind

Follow-up

39 to 58 months

Key result

High doses of lisinopril led to 12% lower risk of death or hospitalization and 24% fewer heart failure hospitalizations compared to low doses.

Authors

MPMilton PackerPPPhilip A. Poole‐WilsonPAPaul W. Armstrong

Discussion

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Overview

High-dose lisinopril reduces death or hospitalization in chronic HF; confirms prior evidence favoring higher ACE inhibitor targets.

Structured PICO

Does high-dose lisinopril reduce morbidity and mortality compared to low-dose lisinopril in patients with chronic heart failure?

P
Population
Patients with New York Heart Association class II to IV heart failure and an ejection fraction ≤30%
I
Intervention
High doses of lisinopril (32.5 to 35 mg daily) added to background heart failure therapy
C
Comparator
Low doses of lisinopril (2.5 to 5.0 mg daily) added to background heart failure therapy
O
Outcome
Death and composite of death or hospitalization for any reasonhard clinical

High-dose lisinopril significantly reduces the combined risk of death or hospitalization compared to low-dose lisinopril in patients with chronic heart failure, supporting the use of higher target doses.

Cite This Study

Packer et al. (1999) studied this question. High doses of lisinopril led to 12% lower risk of death or hospitalization and 24% fewer heart failure hospitalizations compared to low doses.

synapsesocial.com/papers/697817f9f226c9e734a25b73https://doi.org/10.1161/01.cir.100.23.2312
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