CHARM trial programme

Last reviewed 02/2023

The CHARM trial programme asked the question: should angiotensin receptor antagonists be given to patients with heart failure who are already taking angiotensin-converting enzyme inhibitors (ACE inhibitors)?

There were three individual trials:

1. CHARM-Alternative - effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors
2. CHARM-Added - effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors
3. CHARM-Preserved - effects of candesartain in patients with chronic heart failure and preserved left-ventricular ejection fraction

These trials showed that, in patients with chronic heart failure, the angiotensin receptor blocker candesartan led to a reduction in mortality (especially cardiovascular) and hospital admissions for worsening chronic heart failure. The most benefit was seen in patient with reduced left ventricular ejection fraction with or without baseline angiotensin converting enzyme inhibitor treatment.