{"id":"846e99169008","type":"article","url":"https://hartvaat.nl/2024/08/01/candesartan-dosering-bij-mannen-versus-vrouwen-met-chronisch-hartfalen/","title":"Candesartan dosering bij mannen versus vrouwen met chronisch hartfalen","title_en":"Achieved dose and treatment discontinuation of candesartan in men and women with chronic heart failure: data from CHARM.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"ESC heart failure","doi":"10.1002/ehf2.14715","source_url":"https://doi.org/10.1002/ehf2.14715","authors":["Hailun Qin","Pooja Dewan","Bernadet T Santema","Jozine M Ter Maaten","Karl Swedberg","John J V McMurray","Adriaan A Voors"],"significance":5,"published":"2024-08-01","source_date":"2024-08-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/bnp-en-nt-probnp/","https://hartvaat.nl/kennis/farmacologie/lisdiuretica-furosemide-bumetanide/"],"congress":"","summary_en":"Analysis of the CHARM programme showed that women with heart failure achieved lower doses of candesartan than men yet experienced comparable clinical benefit. These findings support consideration of lower dose targets in women with heart failure.","created":"2026-07-03T10:31:04Z","updated":"2026-07-03T13:30:06Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse toonde dat vrouwen met hartfalen lagere doses candesartan bereiken dan mannen maar vergelijkbaar voordeel ervaren. Dit ondersteunt lagere doseringsstreefwaarden bij vrouwen als aanvulling op het beschikbare bewijs.","abstract_original":"AIMS: Angiotensin receptor blockers have been shown to reduce heart failure hospitalization and cardiovascular mortality in men and women with heart failure with reduced ejection fraction (HFrEF). It is unknown whether there are differences between men and women in achieved dose and treatment discontinuation due to adverse events of candesartan. METHODS AND RESULTS: We conducted a post hoc analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme. A total of 3172 men and 1106 women with HFrEF [left ventricular ejection fraction (LVEF) ≤ 40%] in New York Heart Association class II-IV were randomized to candesartan or placebo. Every 2 weeks, patients were up-titrated from 4 or 8, to16, to 32 mg once daily, unless a higher dose was contraindicated or not tolerated. Women were older (66 vs. 64 years), had a higher LVEF (29.9% vs. 28.6%), and had more hypertension (54% vs. 47%) than men. The mean achieved dose of candesartan was 21.5 ± 12.6 mg in men and 20.7 ± 12.9 mg in women (P = 0.19). In both the candesartan and placebo groups, cardiovascular death and heart failure hospitalizations were higher in men and women who achieved lower dose levels. Event rates for achieved dose levels of 0, 4 or 8, 16, and 32 mg candesartan were 20.8, 17.2, 14.0, and 10.1 per 100 person-years in men, respectively, and 23.6, 13.7, 14.0, and 9.1 per 100 person-years in women, respectively. In each of the achieved dose levels, there was no sex difference in the proportion of patients with an event, neither in the candesartan group nor in the placebo group (P-value for all > 0.05). There was no significant interaction between sex and treatment-related discontinuation for hypotension (P = 0.520), an increase in creatinine (P = 0.102), and hyperkalaemia (P = 0.905). CONCLUSIONS: 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."}