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April 20, 2011

Candesartan vs Losartan and Mortality in Patients With Heart Failure

JAMA. 2011;305(15):1540-1542. doi:10.1001/jama.2011.462

To the Editor: Dr Eklind-Cervenka and colleagues provided a retrospective analysis of the Swedish Heart Failure Registry showing a survival benefit of candesartan over losartan in patients with heart failure (HF) at 1 and 5 years.1 The association of lower mortality with candesartan was found both in patients with depressed (<40%) and preserved (≥40%) left ventricular ejection fraction. Although the authors offered various explanations for this benefit, they did not mention that losartan has never shown a benefit over any other angiotensin II–receptor blocker (ARB) or angiotensin-converting enzyme (ACE) inhibitor in HF patients.