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Which results to believe?

If clinicians consider the totality of the evidence from these two observational studies and the randomized clinical trials that they appear to contradict, we can arrive at two sound conclusions: First, it is reasonable to use RAS antagonists to control hypertension in HF with preserved ejection fraction; second, aldosterone antagonists are effective but should be used carefully and selectively in patients who have HF with reduced ejection fraction, said Dr. James C. Fang.

"Although clinical trials should remain the gold standard for testing hypotheses, observational studies bridge the gap from the scientific rigor of clinical trials to real-world experience," he said.

DR. FANG is at University Hospitals Case Medical Center, Cleveland. He had no financial conflicts of interest. These remarks were taken from his editorial accompanying the reports by Dr. Hernandez and Dr. Lund (JAMA 2012;308:2144-6).

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Title Annotation:heart failure treatment; VIEW ON THE NEWS
Publication:Internal Medicine News
Article Type:Brief article
Date:Dec 1, 2012
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