Evid Based Med 18:226-227 doi:10.1136/eb-2013-101238
  • Prognosis
  • Cohort study

Lack of definitive evidence for the use of renin-angiotensin system antagonists for heart failure with preserved ejection fraction

  1. Anita Deswal1,2
  1. 1Department of Medicine, Baylor College of Medicine, Houston, TX, USA
  2. 2Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
  1. Correspondence to Dr Anita Deswal
    Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, 111 B, 2002 Holcombe Boulevard, Houston, TX 77030, USA; adeswal{at}

Commentary on


Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately half of all patients with HF in the community.1 The condition is associated with substantial morbidity and mortality, yet no medications have been proven to reduce mortality in these patients. Debate continues about HFpEF and HF with reduced ejection fraction (HFrEF) representing overlapping or distinct phenotypes within the HF spectrum.2 ,3 The benefit of renin-angiotensin system (RAS) antagonists including ACE inhibitors (ACEI) and angiotensin receptor blockers (ARBs) is well established in reducing mortality and morbidity in HFrEF. Although RAS activation …

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