TEC: Evidence Based Therapeutics
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Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 101: Target doses for CHF – is there collateral damage when shooting for targets?

In episode 101, your friendly centurions, James and Mike, take a shot at the evidence around target doses for drugs in CHF and find the data is not as compelling as one might think. They discuss the approach of making sure we don’t cause side effects trying to get patients to these targets.  To prove the point, we both took high doses of ACE inhibitors, ARBs, and beta-blockers at the beginning of the podcast and the recording results clearly demonstrate the harm  that can occur from arbitrary use of high doses of medications.

Show notes

1) Getting to carvedilol doses

QJM 2004;97: 133-9

2) Network – ACE doses

Eur Heart J 1998;19:481-9

3) ATLAS – ACE doses

Circ 1999;100:2312-8

4) Carvedilol doses

Circulation 1996;94:2807-16

4) Beta-blocker doses

Ann Intern Med 2009;150:784-94

5) HEAAL – losartan

Lancet 2009;374;1840-8

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