ACE and heart failure: In the Effects of High-dose vs. Low-dose Losartan on Clinical Outcomes in Patients with Heart Failure (HEAAL) study, the authors performed a randomized, double-blind trial in 255 sites with 3,846 heart failure patients (30% women) with a NYHA class II-IV, LVEF ≤40% and an ACE inhibitor intolerance (206).