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Citations 0
May 1, 2002

Treatment of Congestive Heart Failure

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(17):2209-2210. doi:10.1001/jama.287.17.2209

To the Editor: In their Scientific Review article about the management of advanced heart failure, Dr Nohria and colleagues1 suggested that angiotensin II receptor blockers (ARBs) are a reasonable alternative for patients who cannot tolerate angiotensin converting enzyme (ACE) inhibitors because of severe cough or angioedema. Although we agree that ARBs, or a combination of hydralazine and a nitrate, constitute a reasonable alternative in patients experiencing persistent cough associated with receiving ACE inhibitors, we believe that ARBs in patients with a history of an ACE inhibitor–associated angioedema should only be used with extreme caution, if at all.