Irbesartan for Heart Failure with Preserved Ejection Fraction

To the Editor: Although irbesartan failed to improve outcomes in patients with heart failure and a preserved ejection fraction in the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) study, Massie et al. (Dec. 4 issue) 1 provide us with a better understanding of this disease. In contrast with observational studies showing a mortality of 22 to 29% after 1 year, 2 , 3 in the I-PRESERVE study, the mortality was 5.2% per year. The prognosis was better in part because of the exclusion of patients with serious coexisting conditions. Yet even in this population of patients with “isolated” heart failure and . . .