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ACE inhibitor intolerance and lessons learned from the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) trials.
Congest Heart Fail 2004 May-Jun; 10(3):160-4CH

Abstract

The Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) trials looked at the effects of candesartan in addition to best possible treatment for heart failure in 7601 patients. CHARM encompassed three studies in discrete populations, including patients with left ventricular dysfunction taking angiotensin-converting enzyme (ACE) inhibitors (CHARM-Added), patients with maintained left ventricular function (CHARM-Preserved), and patients with left ventricular dysfunction and an intolerance to ACE inhibitors (CHARM-Alternative). CHARM-Alternative was considered a success in that its participants experienced a significant reduction in each component of the study's primary end point, which was a composite of cardiovascular death or hospitalization for heart failure, over a median follow-up of 34 months. Candesartan was by and large well tolerated in these ACE-inhibitor intolerant patients; thus, the findings of this study provide additional support for the effectiveness of angiotensin receptor blocker therapy in heart failure patients poorly tolerant of an ACE inhibitor; however, candesartan was not convincingly shown to improve the incidence/severity of hypotension, hyperkalemia, and glomerular filtration rate reductions that were the basis for ACE inhibitor intolerance in approximately 25% of the study population.

Authors+Show Affiliations

Virginia Commonwealth University, MCV Station Box 980160, Richmond, VA 23298-0160, USA. dsica@hsc.vcu.edu

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15184734

Citation

Sica, Domenic A.. "ACE Inhibitor Intolerance and Lessons Learned From the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Trials." Congestive Heart Failure (Greenwich, Conn.), vol. 10, no. 3, 2004, pp. 160-4.
Sica DA. ACE inhibitor intolerance and lessons learned from the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) trials. Congest Heart Fail. 2004;10(3):160-4.
Sica, D. A. (2004). ACE inhibitor intolerance and lessons learned from the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) trials. Congestive Heart Failure (Greenwich, Conn.), 10(3), pp. 160-4.
Sica DA. ACE Inhibitor Intolerance and Lessons Learned From the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Trials. Congest Heart Fail. 2004;10(3):160-4. PubMed PMID: 15184734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - ACE inhibitor intolerance and lessons learned from the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) trials. A1 - Sica,Domenic A, PY - 2004/6/9/pubmed PY - 2004/9/8/medline PY - 2004/6/9/entrez SP - 160 EP - 4 JF - Congestive heart failure (Greenwich, Conn.) JO - Congest Heart Fail VL - 10 IS - 3 N2 - The Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) trials looked at the effects of candesartan in addition to best possible treatment for heart failure in 7601 patients. CHARM encompassed three studies in discrete populations, including patients with left ventricular dysfunction taking angiotensin-converting enzyme (ACE) inhibitors (CHARM-Added), patients with maintained left ventricular function (CHARM-Preserved), and patients with left ventricular dysfunction and an intolerance to ACE inhibitors (CHARM-Alternative). CHARM-Alternative was considered a success in that its participants experienced a significant reduction in each component of the study's primary end point, which was a composite of cardiovascular death or hospitalization for heart failure, over a median follow-up of 34 months. Candesartan was by and large well tolerated in these ACE-inhibitor intolerant patients; thus, the findings of this study provide additional support for the effectiveness of angiotensin receptor blocker therapy in heart failure patients poorly tolerant of an ACE inhibitor; however, candesartan was not convincingly shown to improve the incidence/severity of hypotension, hyperkalemia, and glomerular filtration rate reductions that were the basis for ACE inhibitor intolerance in approximately 25% of the study population. SN - 1527-5299 UR - https://www.unboundmedicine.com/medline/citation/15184734/ACE_inhibitor_intolerance_and_lessons_learned_from_the_candesartan_in_heart_failure:_assessment_of_reduction_in_mortality_and_morbidity__CHARM__trials_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1527-5299&date=2004&volume=10&issue=3&spage=160 DB - PRIME DP - Unbound Medicine ER -