Effect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure

CONGESTIVE heart failure is a major and growing public health problem. About 2 million patients have congestive heart failure in the United States, and the number is expected to increase substantially in the next few decades. 1 The one-year mortality ranges from 15 percent among relatively unselected patients 2 to 50 percent among those in New York Heart Association functional class IV. 3 About 35 percent of all patients with a diagnosis of congestive heart failure are hospitalized every year (unpublished data). The Veterans Administration Cooperative Vasodilator Heart Failure Trial 4 reported a lower mortality in patients with congestive heart failure treated with hydralazine . . .