The CHARM program: study design leads to findings of clinical and public health importance.
In large-scale randomized trials and their meta-analyses, beta-adrenergic blockers and angiotensin-converting enzyme inhibitors provide statistically significant and clinically important additive mortality and morbidity benefits in the treatment of heart failure. The CHARM trials were designed to test whether the angiotensin-receptor blocker candesartan would provide statistically significant and clinically important additive mortality and morbidity benefits to patients with heart failure as an alternative or in addition to angiotensin-converting enzyme inhibitors. CHARM demonstrated that an angiotensin-receptor blocker at a proven dose is an effective and safe therapy as an alternative or in addition to angiotensin-converting enzyme inhibitors in patients with heart failure, 55% of whom were receiving beta-adrenergic blockers. These benefits include reductions in cardiovascular mortality rate as well as in hospitalization for heart failure. Such patients have a 50% mortality rate at 5 years, and heart failure is the leading cause of hospitalization for patients 65 years of age and older.
Hennekens
Charles H
CH
Florida Atlantic University, Boca Raton, Florida, and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Pfeffer
Marc A
MA
Swedberg
Karl
K
D000319:Adrenergic beta-Antagonists; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D006760:Hospitalization; D006801:Humans; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D013777:Tetrazoles / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan