In Other Journals

In chronic heart failure, a Lancet commentary advises that patients whose ejection fraction is 40% or less should be prescribed angiotensinreceptor blockers in addition to ACE inhibitors, β-blockers and/or spironolactone.¹ Further, angiotensin-receptor β-blockers should be used as an alternative drug in patients with intolerance to ACE inhibitors, and considered in patients whose ejection fraction is more than 40%. The author was commenting on four papers reporting the results of the CHARM — the Candesartan in Heart Failure Assessment of Reduction in Mortality and Morbidity — program.² CHARM, involving more than 7000 adults with chronic heart failure living in 26 countries including Australia, found that the angiotensinreceptor blocker candesartan reduced cardiovascular deaths and hospital admissions for heart failure.