TY - JOUR T1 - Candesartan reduced mortality and hospital admissions in chronic heart failure JF - Evidence Based Medicine JO - Evid Based Med SP - 44 LP - 45 DO - 10.1136/ebm.9.2.44 VL - 9 IS - 2 A2 - , Y1 - 2004/03/01 UR - http://ebm.bmj.com/content/9/2/44.abstract N2 - Pfeffer MA, Swedberg K, Granger CB, et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 2003;362:759–66.OpenUrlCrossRefPubMedWeb of Science
 Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Cardiology ★★★★★★☆
 
 McMurray JJ, Östergren J, Swedberg K, et al Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial Lancet 2003;362:767–71.OpenUrlCrossRefPubMedWeb of Science
 Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★★☆☆
 
 Granger CB, McMurray JJ, Yusuf S, et al Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial Lancet 2003;362:772–6.OpenUrlCrossRefPubMedWeb of Science
 Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★★★☆
 
 Yusuf S, Pfeffer MA, Swedberg K, et al Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved trial Lancet 2003;362:777–81.OpenUrlCrossRefPubMedWeb of Science
 Clinical impact ratings GP/FP/Primary care ★★★★☆☆☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★★★★
 
 
 Q In patients with chronic heart failure (CHF), does the angiotensin-receptor blocker (ARB) candesartan reduce death and hospital admissions? Design: 3-component randomised, placebo controlled trial (Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity [CHARM] study). Allocation: concealed.* Blinding: blinded (clinicians, patients, data collectors, outcome assessors, monitoring committee, manuscript writers, and data analysts).* Follow up period: median 37.7 months. Setting: 618 centres in 26 countries. Patients: 7601 patients who were ⩾18 years of age and had symptomatic CHF (New York Heart Association class II–IV) for ⩾4 weeks. Major exclusion criteria included serum creatinine ⩾265 μmol/l; serum potassium ⩾5.5 mmol/l; bilateral renal artery stenosis; symptomatic hypotension; critical aortic or mitral stenosis; myocardial infarction, stroke, or open heart surgery in the previous 4 weeks; use of an ARB in the previous 2 weeks; other serious disease likely to limit 2 year survival; and potential for pregnancy. Patients were enrolled in 1 of 3 component trials: CHARM-Added involved patients with left ventricular ejection fraction (LVEF) ⩽40% who were being treated with an angiotensin converting enzyme (ACE) inhibitor for ⩾30 days (n = 2548); CHARM-Alternative involved patients with LVEF ⩽40% who were intolerant of ACE inhibitors (n = 2028); … ER -