- Question
- Does adding the angiotensin-receptor blocker valsartan to standard therapy improve outcomes in patients with chronic heart failure?
- Design
- Randomized, placebo-controlled trial enrolling 5010 patients with heart failure, with long-term follow-up.
- Population
- Patients with heart failure in NYHA class II, III, or IV who were receiving the usual recommended treatment for the condition.
- Intervention
- Valsartan 160 mg twice daily, added to standard therapy.
- Control
- Placebo, added to standard therapy.
- Primary outcome
- Two primary outcomes: mortality, and a combined end point of mortality and morbidity (cardiac arrest with resuscitation, hospitalization for heart failure, or intravenous inotropic or vasodilator therapy for at least four hours).
- Results
- Overall mortality was similar between groups. The combined end point was 13.2% lower with valsartan (relative risk 0.87; 97.5% CI 0.77 to 0.97; P=0.009), mainly due to fewer heart failure hospitalizations (346 patients, 13.8%, with valsartan vs 455, 18.2%, with placebo; P<0.001).
- Safety
- In a post hoc subgroup analysis, the effect was favorable in patients receiving neither or only one of the drug classes (ACE inhibitor or beta-blocker) but adverse in those receiving both along with valsartan, raising a safety concern about that combination.
- Conclusion
- Valsartan added to usual therapy reduced the combined end point of mortality and morbidity and improved signs and symptoms, without changing overall mortality.
- Why it matters
- It showed that angiotensin-receptor blockade on top of standard therapy provides clinical benefit in heart failure, although the safety signal with the triple combination prompted caution and debate about that regimen.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 10, 2026