Although about half of CHF patients have a preserved EF, no meds have been shown to improve patient outcomes. This industry sponsored RCT of >4000 patients, age >60, with CHF and EF > 45% found no difference in mortality or cardiovascular hospitalization between those randomized to irbesartan or placebo (consistent across all measured subgroups) after mean f/u of >4 years. The irbesartan patients were more likely to have at least 1 measured doubling of creatinine. There is no clear role for ARBs in normal EF CHF (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.