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According to results presented at the Heart Failure Society of America Annual Scientific Meeting, dose reduction occurred in 42% of the valsartan/sacubitril group and 43% of the enalapril group during the course of the study. Hypotension was the most cited reason for dose reduction in the valsartan/sacubitril group and cough in the enalapril group. Dose reduction was more common in patients who were older, sicker, had higher levels of serum creatinine and NT-proBNP at baseline, and had an implantable cardioverter defibrillator or cardiac resynchronization therapy device, according to Orly Vardeny, PharmD, MS, from the University of Wisconsin School of Pharmacy.

http://www.healio.com/cardiology/hf-tra ... ower-doses
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