Clinical outcomes according to baseline blood pressure in patients with a low ejection fraction in the CHARM (Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity) Program.

Journal Article (Journal Article)

OBJECTIVES: This study sought to investigate the efficacy and tolerability of candesartan, according to baseline blood pressure (BP), in the 4,576 patients with a low ejection fraction (EF) (or=141 mm Hg) and 4 DBP categories (or=81 mm Hg). RESULTS: Low SBP and DBP were associated with worse clinical outcomes. Baseline BP did not modify the effects of candesartan on clinical outcomes: the interaction p value between SBP category and treatment was 0.38 (0.22 for DBP category). For both placebo and candesartan, study drug discontinuation for adverse effects (especially hypotension) was highest in patients in the lowest baseline BP categories. However, the relative risk of discontinuation for hypotension, renal dysfunction, and hyperkalemia in the candesartan compared with placebo group was not increased in patients with a low baseline BP. CONCLUSIONS: In patients with low EF heart failure, the relative risks and benefits of candesartan treatment were similar in patients with a low BP compared to those with a higher BP.

Full Text

Duke Authors

Cited Authors

  • Meredith, PA; Ostergren, J; Anand, I; Puu, M; Solomon, SD; Michelson, EL; Olofsson, B; Granger, CB; Yusuf, S; Swedberg, K; Pfeffer, MA; McMurray, JJV

Published Date

  • December 9, 2008

Published In

Volume / Issue

  • 52 / 24

Start / End Page

  • 2000 - 2007

PubMed ID

  • 19055992

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2008.09.011


  • eng

Conference Location

  • United States