During follow-up, 2,378 participants died -- 330 taking candesartan and 1,212 patients taking losartan, the researchers found.
However, there was no significant increased risk of all-cause death or cardiovascular death associated with losartan compared to candesartan, the researchers said.
But dosage was important, the team said. The study found twice the risk of death with low-dose losartan compared to high-dose candesartan. Medium-dose losartan and low-dose candesartan also had a higher risk of death, but high-dose losartan had no increased death risk compared to high doses of candesartan.
"Our data provide a more detailed insight into the complexity of the association between losartan use and mortality risk in heart failure," the researchers concluded.
"These findings do not support the hypothesis of differential effects of specific ARBs in patients with heart failure," they added.
Dr. David Friedman, chief of heart failure services at North Shore-LIJ Health System's Plainview Hospital in Plainview, N.Y., said, "These medications are very helpful in heart failure patients."
Friedman noted that those in the losartan group were older and sicker, which may explain why more of them died.
These patients could only tolerate lower doses of losartan, and because they were sicker they were more likely to die than patients who could tolerate higher starting doses of candesartan, he said.
For more on heart failure, visit the American Heart Association.
SOURCES: Gregg Fonarow, M.D., director, Ahmanson-UCLA Cardiomyopathy Center, and co-director, UCLA Preventative Cardiology Program, Los Angeles; David A. Friedman, M.D., chief, heart failure services, North Shore-LIJ Health System's Plainview Hospital, Plainview, N.Y.; April 11,
All rights reserved