Heart failure & cardiomyopathies
Achieved Dose and Treatment Discontinuation of Candesartan in Men and Women with Chronic Heart Failure: Data from CHARM
Authors' conclusion
In a randomized clinical trial in patients with HFrEF, men and women achieved similar doses of candesartan. Primary event rates and treatment-related discontinuation due to adverse events were also similar between men and women.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) (left ventricular ejection fraction (LVEF) ≤ 40%) in NYHA class II–IV randomised to candesartan or placebo
- Participants
- 3,172 vs 1,106
- Comparison
- Men vs women: achieved candesartan dose and discontinuation due to AEs
- Menn = 3,172reference
- Womenn = 1,106
- Primary endpoint
- Achieved dose of candesartan and treatment discontinuation due to adverse events, by sex
Methodological detailspost hoc analysis, Up-titration every 2 weeks from 4 or 8, to 16, to 32 mg once daily unless contraindicated or not tolerated
- Post hoc analysis
- Up-titration every 2 weeks from 4 or 8, to 16, to 32 mg once daily unless contraindicated or not tolerated
Primary result
As reported in the abstract
Mean achieved candesartan dose
P = 0.19
Further findings
Per 100 person-years
| Outcome | Men | Women |
|---|---|---|
| Event rates (CV death or HF hospitalisation) by achieved dose level 0, 4 or 8, 16, 32 mg | ||
| 0 mg | 20.8 | 23.6 |
| 4 or 8 mg | 17.2 | 13.7 |
| 16 mg | 14.0 | 14.0 |
| 32 mg | 10.1 | 9.1 |
- Event rates (CV death or HF hospitalisation) by achieved dose level 0, 4 or 8, 16, 32 mg — No sex difference in proportion with an event at any dose level, in candesartan or placebo group
- P-value for all > 0.05
Event rates (CV death or HF hospitalisation) by achieved dose level 0, 4 or 8, 16, 32 mg
- CV death and HF hospitalisations higher at lower achieved dose levels in men and women, in both candesartan and placebo groups
Safety
Treatment-related discontinuation: sex interaction
- Hypotension: no significant sex interaction
- P = 0.520
- Increase in creatinine: no significant sex interaction
- P = 0.102
- Hyperkalaemia: no significant sex interaction
- P = 0.905
Original publication
Achieved Dose and Treatment Discontinuation of Candesartan in Men and Women with Chronic Heart Failure: Data from CHARM. ESC Heart Fail. Published 5 April 2024. doi:10.
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