TY - JOUR T1 - Compared with low-dose losartan, high-dose losartan decreases risk of death or hospital admission for heart failure in people with heart failure who are intolerant to ACE inhibitors JF - Evidence Based Medicine JO - Evid Based Med SP - 51 LP - 52 DO - 10.1136/ebm1051 VL - 15 IS - 2 AU - Robert McKelvie Y1 - 2010/04/01 UR - http://ebm.bmj.com/content/15/2/51.abstract N2 - Commentary on: Konstam MA, Neaton JD, Dickstein K, et al. Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial. Lancet 2009;374:1840–8.OpenUrlCrossRefPubMedWeb of Science This study by Konstam and colleagues in some ways expands on the findings of the Evaluation of Losartan in the Elderly II (ELITE II) study,1 which compared the effects of losartan 50 mg/day and captopril 150 mg/day. The ELITE II study found that the angiotensin receptor blocker (ARB) losartan was not superior to captopril, and the study design meant that it could not be concluded that losartan was non-inferior to captopril.1 After publication of ELITE II there was speculation that the lack of benefit observed was due to the dose of losartan being too low, because losartan 100 mg/day was found to be effective in improving clinical outcome in the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE)2 and Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL)3 studies. Thus the Heart failure Endpoint evaluation of Angiotensin II Antagonist Losartan (HEAAL) study was designed to examine whether losartan 150 mg/day would be more effective than losartan 50 … ER -