To the Editors:
I appreciated the topic addressed in the Cardiology Casebook column titled “Statin Therapy in Congestive Heart Failure” (2005;14:338–340); however, I am concerned with several points in the case. When listing the medications the patient was taking, the authors noted that eplerenone was prescribed at a dose of 50 mg twice a day when in fact the recommended dose, and doses used in the clinical trial for heart failure, is 50 mg daily. In reality, enalapril should be administered at a target does of 20 mg twice a day.
If utilizing evidence-based medicine, the answer to the first question, “Which one of the following medications is vital to the management of CHF [congestive heart failure]?” should be angiotensin-converting enzyme inhibitors, β-blockers, and aldosterone receptor blockers. These medications have all been shown to improve morbidity and mortality. Diuretic therapy in CHF has never been shown in clinical trials to...