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CONSENSUS

TreatmentCardiology1987
PurposeTreatment
FieldCardiology
Year1987
Key FindingEnalapril cut mortality in severe heart failure by 40 percent

About the Trial

The Cooperative North Scandinavian Enalapril Survival Study randomized 253 patients with severe congestive heart failure, NYHA class IV, to enalapril or placebo. Enalapril reduced 6 month mortality from 44 percent to 26 percent and 1 year mortality by 31 percent. This small trial in the sickest patients proved the renin angiotensin system drives progression of heart failure, not just hypertension. Along with SOLVD, it established ACE inhibitors as the foundation of heart failure therapy. CONSENSUS demonstrated that a pathophysiologically targeted drug could transform a uniformly fatal disease, launching the modern neurohormonal era of heart failure treatment.

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