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Reascher:I’d like to talk today about heart failure specifically. We have seen several lead breaking heart failure trials presented here at AHA 2009 and one of those trials was the HEAAL study. Can you give us your brief opinion on the HEAAL study as well as any comments about how we can evaluate it? Additionally, what do you think the contribution is to the progress regarding how we can treat heart failure?

 Prof. Nissen:We don’t use Losartan very often for heart failure primarily because we have very good data for another group of drugs. In my opinion, the data for the ACE inhibitors is very good and that they should be the first line agent for heart failure. Perhaps 3%~5% of patients in this country will get cough from the ACE inhibitors and in those patients we have been using Candesartan because the very large, very successful trial, CHARM, showed benefit. The high versus low dose Losartan trial really tells us a lot more about the fact that the traditional doses of Losartan that have been used were probably too low. The drug was launched with the wrong dose and now, 15 years later, have found the right dose of Losartan but I don’t think it is going to have a terribly large impact on our practice.

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Comment by fayaz mujtaba on May 20, 2011 at 10:44am
in my opinion arb should not be considered as alternative to acei when there are no contraindication to use of former. secondly there is data that losartan actually increases mortality in heart failure patients so it should not be used.

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