Translation of clinical trial results into practice.
Angiotensin-converting enzyme (ACE) inhibitors have been shown in several large studies to prolong life and prevent disease progression in patients with heart failure and to prevent progression of left ventricular dysfunction following myocardial infarction. Despite this, it appears that a significant proportion of eligible patients are not receiving these agents and not obtaining their benefits. Patients in clinical trials are generally more selected and homogeneous than heart failure patients in the community. Clinicians may often feel that the typical clinical trial patient is not representative of many patients in their own practices and that trial results are often not generalizable to practice. It is only with the emergence of evidence from trials which more closely represent community practice and the promotion of agreed management guidelines that ACE inhibitors will be used more widely. Specialists and primary care practitioners need to provide an integrated approach to heart failure management to achieve optimal outcomes for patients.
Sharpe
N
N
Department of Medicine, University of Auckland, New Zealand.
D017677:Age Distribution; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000453:epidemiology; D002986:Clinical Trials as Topic; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008511:Medicine / Q000379:methods; D010818:Practice Patterns, Physicians'; D017678:Sex Distribution; D013038:Specialization
D000806:Angiotensin-Converting Enzyme Inhibitors