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Experts have long debated the appropriateness of prescribing aspirin to heart failure patients. Some argue that aspirin might exacerbate hypertension, worsen renal function, and antagonize the benefit of ACE inhibitors in HF patients, but randomized trial data have not been conclusive. Now, researchers in Canada have conducted an observational study of 7352 patients (mean age, 75) who survived a first hospitalization for HF from April 1999 through March 2001; HF was nonischemic in 44%. Of 3073 patients in whom systolic versus diastolic dysfunction was explicitly defined, 48% had systolic dysfunction. At discharge, 64% of the entire cohort received an ACE inhibitor and 42% received aspirin.
Among patients not prescribed ACE inhibitors at disc…