What is the clinical evidence from this study?

Study design: RCT. Population: heart failure. Intervention: ACE inhibitor vs. low daily dose. Primary outcome: mortality rate.

What question did this study set out to answer?

To determine the effects of high versus low doses of ACE inhibitors on mortality and hospitalization rates in heart failure patients.

November 1, 1998Cleveland Clinic Journal of Medicine

High or low doses of ACE inhibitors for heart failure?

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Key result

A large daily dose of an ACE inhibitor lowered the hospitalization rate and showed a trend toward lower mortality compared to a low daily dose in patients with heart failure.

Why the study?

Does a large daily dose of an ACE inhibitor reduce mortality and hospitalization in patients with heart failure compared to a low daily dose?

Population

patients with heart failure

Comparison

large daily dose of an angiotensin-converting… vs low daily dose of an angiotensin-converting…

Design

Editorial, randomized

Authors

RHRobert E. HobbsCleveland Clinic

Discussion

Member takes

Implication

Maximal tolerated doses of ACE inhibitors should be used in heart failure patients to optimize clinical benefits, including reduced hospitalizations.

Key Points

To determine the effects of high versus low doses of ACE inhibitors on mortality and hospitalization rates in heart failure patients.
Large randomized study comparing high and low daily doses of ACE inhibitors in heart failure patients.
Evaluation of mortality rates, hospitalization rates, and side-effect profiles between two dose groups.
Patients on high-dose ACE inhibitors showed a trend toward lower mortality rates compared to low-dose group.
Hospitalization rates were lower in the high-dose group.
Side-effect profiles were similar across both dosage groups.

Study Design

Type

RCT

Randomization

randomized

Structured PICO

Does a large daily dose of an ACE inhibitor reduce mortality and hospitalization in patients with heart failure compared to a low daily dose?

Population

patients with heart failure

Intervention

large daily dose of an angiotensin-converting enzyme inhibitor

Comparator

low daily dose of an angiotensin-converting enzyme inhibitor

Outcome

mortality ratehard clinical

Maximal tolerated doses of ACE inhibitors should be used in heart failure patients to optimize clinical benefits, including reduced hospitalizations.

Cite This Study

Robert E. Hobbs (1998) conducted an RCT in heart failure. ACE inhibitor vs. low daily dose was evaluated on mortality rate. A large daily dose of an ACE inhibitor lowered the hospitalization rate and showed a trend toward lower mortality compared to a low daily dose in patients with heart failure.

synapsesocial.com/papers/6a0873c0ab15ea61dee8db28 https://doi.org/10.3949/ccjm.65.10.539

Topics

Heart failure HFrEF treatment Heart failure hospitalization

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Implication

Maximal tolerated doses of ACE inhibitors should be used in heart failure patients to optimize clinical benefits, including reduced hospitalizations.

High or low doses of ACE inhibitors for heart failure?

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

High or low doses of ACE inhibitors for heart failure?

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider