Candesartan vs Losartan in heart failure treatment

January 01, 0001

Candesartan vs Losartan in heart failure treatment

Angiotensin II receptor blockers (ARBs) have been shown to have a mortality benefit in some patients with heart failure (HF), though there has been little work comparing the effect of different ARBs. These Swedish researchers assessed candesartan vs losartan regarding all-cause mortality in patients with HF using a registry (the Swedish Heart Failure Registry). Subsets of the patients were treated with either candesartan (n = 2639) or losartan (n = 2500). Kaplan-Meier method along with univariate and multivariate proportional hazard regression models were used to analyze survival.

The researchers found: "One-year survival was 90% for patients receiving candesartan and 83% for patients receiving losartan, and 5-year survival was 61% and 44%, respectively (log-rank P < .001). In multivariate analysis with adjustment for propensity scores, the hazard ratio for mortality for losartan compared with candesartan was 1.43. The results persisted in stratified analyses."

The researchers concluded: "In this registry of patients with HF, the use of candesartan compared with losartan was associated with a lower mortality risk."

These data reinforce that different drugs in a class shown to have benefit may have varying efficacy

For the full abstract, click here.

JAMA 305(2):175-182, 12 January 2011 © 2011 American Medical Association
Candesartan vs Losartan With All-Cause Mortality in Patients With Heart Failure. Maria Eklind-Cervenka, Lina Benson, Ulf Dahlström, Magnus Edner, Mårten Rosenqvist, Lars H. Lund.

Category: K. Circulatory. Keywords: angiotensin receptor blocker, ARB, losartan, candesartan, heart failure, cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 28 January 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.