I read with interest Juanita Reigle’s excellent answer regarding the use of angiotensin-receptor blockers (ARBs) in patients with heart failure (Ask the Experts, December 2004:67–69). As she correctly notes, “the prescription of an ACE inhibitor at hospital discharge is used by various regulatory agencies as a quality indicator.” On the basis of the studies she cites and others, effective for hospital discharges after January 1, 2005, both the Joint Commission on Accreditation of Healthcare Organizations and the Centers for Medicare & Medicaid Services will revise this quality indicator to also include the use of ARBs. See CMS.gov for details.

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