ABSTRACT
It is possible that RAAS inhibition might also be of benefit in patients with CHF and preserved LV systolic function. These patients are treated with diuretics which may be expected to cause RAAS activation.42 Many are hypertensive, diabetic and have LV hypertrophy, comorbidies that might be expected to respond favorably to RAAS inhibition, especially in the light of the recently reported Heart Outcomes Prevention Evaluation (HOPE) study.45,46 Once more, of course, this is a hypothesis that needs to be tested in an appropriately designed clinical trial. Two trials are under way: one is with the ACE inhibitor perindopril (PEP-CHF)47 and one is a component trial of the CHARM programme.34
