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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We found instructive the article by the Large State Peer Review Organization Consortium¹ suggesting underuse of angiotensin-converting enzyme (ACE) inhibitors in patients with heart failure. It reinforces previous similar demonstrations obtained both in general practice² and in hospital settings,^3-4 and again, it provides disturbing evidence that elderly patients are at greatest risk of underprescription of ACE inhibitors. However, some considerations seem warranted. Although assumed, there is a lack of evidence of benefit from the use of ACE inhibitors in patients older than 70 years; indeed, all the major randomized controlled trials have systematically excluded older patients.⁵ Moreover, the simple documentation of use does not exclude the possibility that inappropriate doses are prescribed. It is documented that the dosages routinely used in clinical practice are substantially lower than those used in the trials, especially in the elderly.⁶

The authors also have elected to consider as ideal candidates for ACE inhibitor therapy . . . [Full Text of this Article]

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effects of Angiotensin-Converting Enzyme Inhibitors and Digoxin on Health Outcomes of Very Old Patients With Heart Failure
Gambassi et al.
Arch Intern Med 2000;160:53-60.
ABSTRACT | FULL TEXT