Underutilization of ACE inhibitors in heart failure

Although the beneficial effects of angiotensin-converting enzyme (ACE) inhi bitors in patients with ventricular systolic dysfunction are well documente d, historically, a large proportion of patients have not received optimal t herapy. Published studies to describe the trends in ACE inhibitor utilizati on and determinants of their use were reviewed. In recent years the number of patients treated with ACE inhibitors has increased; however, a relativel y small proportion of these patients received adequate therapeutic dosages. Attention to factors that impair proper use of these agents is essential. to realize improved outcomes in these patients.