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MeReC Extra 49

The National Prescribing Centre has published MeReC Extra 49 (PDF) which discusses recent important changes to a piece of guidance from the National Institute for Health and Clinical Excellence (NICE) and the results of an observational study of angiotensin receptor blockers (ARBs) in heart failure.

The first topic reviews the changes in the recommendations regarding the use of antithrombotics in for the prevention of occlusive vascular events. It provides a useful summary of the new recommendations reviewing the advice for patients after an ischaemic stroke, transient ischaemic attack, myocardial infarction or those with peripheral arterial disease or mulitvascular disease.

The second topic reviews the results of a recent observational study in patients with heart failure that indicated there may be improved survival in those treated with candesartan compared with losartan. The study did have some limitations such as being an observational study and having no control arm. The article reminds clinicians that ARBs are still only recommended as second line alternatives to angiotensin converting enzyme inhibitors (ACEI) in patients who develop an intolerable cough.

Action: Clinicians who see patients with vascular disease or heart failure will find this information useful and informative.