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Comparison of low and high dose angiotensin converting enzyme inhibitors in congestive heart failure (A meta-analysis).


Kenneth C. Oporto

Related Institution

Adult Cardiology Fellow - Philippine Heart Center

Publication Information

Publication Type
Research Report
January 1-December 31, 2003


Angiotensin converting enzyme (ACE) inhibitors have been proven in several major clinical trials to improve symptoms and prolong life. Yet the dosages used in these trials are oftentimes not attained in clinical practice. A meta-analysis was done to determine if low dose and high ACE inhibitors confer similar benefits in heart failure patients. Two randomized controlled trials comparing low and high dose ACE inhibitors, enalapril(NETWORK study) and lisonopril(ATLAS study), were analyzed. Results showed although there was a tendency towards higher all cause mortality in low dose groups. In contrast there was a tendency toward more heart failure related hospitalisation and higher incidence of side effects in the high dose group. All these differences however, were found to be not statistically significant. Therefore both low dose and high dose ACE inhibitors can give similar benefit in the treatment of heart failure.

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