Physicians' Academy for Cardiovascular Education

Worse survival when using lower than recommended doses of ACEi/ARBs or beta-blockers in heart failure

Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: a prospective European study

Literature - Ouwerkerk W, Voors AA, Anker SD, et al. - European Heart Journal 2017; published online ahead of print

Main results


In the BIOSTAT-CHF study, reaching less than 50% of the recommended dose of ACEi/ARBs and beta-blockers was associated with worse survival. Patients who did not reach the recommended ACEi/ARBs or beta-blocker doses because of intolerance had worse survival compared to patients who did not reach their therapeutic targets because of other reasons. These findings support the adherence with the ESC guidelines on HF therapy, according to which maximum tolerated doses of ACEi/ARBs and beta-blockers are recommended.


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Find this article online at Eur heart J

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