This Week In The Bmj

ACE inhibitors are safe for heart failure in primary care

BMJ 2000; 321 doi: (Published 04 November 2000) Cite this as: BMJ 2000;321:e

Despite firm evidence of their effectiveness, angiotensin converting enzyme inhibitors are underused for patients with heart failure in primary care, and doctors remain concerned about potential side effects. Mason et al (p 1113) analysed individual patient data from the studies of left ventricular dysfunction and found that less than 2% of patients who received a test dose of enalapril experienced side effects severe enough to stop treatment. Angiotensin converting enzyme inhibitors can be started safely in primary care and remain highly cost effective when the costs of diagnosis and starting treatment are included.