Are angiotensin-blocking drugs being used in adequate doses?

Angiotensin-receptor blocking drugs have been shown to be an effective therapeutic strategy in a number of cardiovascular diseases. Many randomised controlled trials have demonstrated optimal doses of these drugs. We therefore investigated the doses of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers in patients admitted to hospital. We found from a total of 60 consecutive patients, only 38% (n=23) were on the top recommended dose and the average daily dose was 63.1±4.5% of the recommended dose. This study confirms that a significant number of patients are receiving suboptimal doses of angiotensin-blocking drugs and this under-dosing is likely to result in a failure to achieve the maximal therapeutic benefit.