Background Angiotensin II type 1 receptor blockers have favourable effects on
haemodynamic measurements, neurohumoral activity, and left-ventricular remodelling when
added to angiotensin-converting-enzyme (ACE) inhibitors in patients with chronic heart
failure (CHF). We aimed to find out whether these drugs improve clinical outcome. Methods
Between March, 1999, and November, 1999, we enrolled 2548 patients with New York
Heart Association functional class II–IV CHF and left-ventricular ejection fraction 40% or …

Background Angiotensin-converting-enzyme (ACE) inhibitors improve outcome of patients
with chronic heart failure (CHF). A substantial proportion of patients, however, experience no
benefit from ACE inhibitors because of previous intolerance. We aimed to find out whether
candesartan, an angiotensin-receptor blocker, could improve outcome in such patients not
taking an ACE inhibitor. Methods Between March, 1999, and March, 2001, we enrolled 2028
patients with symptomatic heart failure and left-ventricular ejection fraction 40% or less who …