Optimal blockade of the renin-angiotensin-aldosterone system

Presentation title: Optimal blockade of the renin-angiotensin-aldosterone system

Author(s): Swedberg K.

Date: 12 June 2005

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Optimal blockade of the renin-angiotensin system		Renin-AngiotensinAldosterone System
	CONSENSUS
ACE-inhibitors	All-Cause Mortality	ACE-inhibitor Trials in Heart Failure/LV-dysfunction Mortality
CONSENSUS 10-year follow-upAll randomised patients, original and follow-up	Renin-AngiotensinAldosterone System	Angiotensin receptor blockers (ARBs)
Mortality by treatment	CHARM Programme	CHARM Programme
CHARM-Added: Primary outcomeCV death or CHF hospitalization	CHARM-Added: Investigator reported CHF hospitalizations	CHARM - Low EF (Alternative+Added): All-cause death
Was the dose of ACE inhibitor too low?	Dose of ACE inhibitor achieved in CHARM-Added compared to randomised outcome trials using forced titration	CHARM Investigators did optimise ACE inhibitor dose
Proportion of patients on “recommended dose” or FDA defined “maximum dose” of ACE inhibitor at baseline	CHARM ADDEDCV Death or HF Hospitalisation—Recommended or maximum ACE inhibitor doses at baseline	CHARM Added
Candesartan and spironolactone?	CHARM Added Primary Endpoint* by Background Therapy	Renin-AngiotensinAldosterone System
		RALESRandomized ALdactone Evaluation Study
Candesartan or spironolactone?	CHARM-Added (NYHA Class III/IV patients): Comparability to RALES
Eplerenone on Mortality	Relative Risk of Sudden Cardiac Death
ESC Guidelines Update 2005	Conclusions