THE ELITE STUDY - WHAT ARE ITS IMPLICATIONS FOR THE DRUG-TREATMENT OFHEART-FAILURE

Angiotensin II type 1 (AT(1)) receptor antagonists inhibit the renin-a ngiotensin system more completely than ACE inhibitors, and do not incr ease bradykinin levels as ACE inhibitors do. ACE inhibitors have been proven to increase survival and improve quality of life in patients wi th congestive heart failure (CHF). At the 48-week follow-up of the Eva luation of Losartan in the Elderly (ELITE) Study, the AT(1) receptor a ntagonist losartan (at a dosage of 50 mg/day) was found to be superior to captopril 50mg 3 times daily in terms of its effects on total mort ality, total mortality and/or hospitalisation for CHF, and hospitalisa tion for any reason. Hospitalisation for CHF was the same for both dru gs. Adverse effects occurred in 12 and 21% of those receiving losartan and captopril, respectively. Cough, rash, angioedema or taste disturb ances/reduced appetite prompted the cessation of drug treatment in 0 a nd 7% of those receiving losartan and captopril, respectively. Until a dditional data are available, this author recommends that elderly pati ents with CHF and an abnormal or normal left ventricular ejection frac tion, and who are unable to tolerate ACE inhibitors, should receive lo sartan 50 mg/day.