Home-based management of patients with chronic heart failure--focus on content not just form!

pronounced. This moderate approach is more in keeping with the average dose actually achieved in the large-scale ACE inhibitor survival trials and in our view is a reasonable target. A more attractive future option would be to tailor therapy to the individual patient. This would allow optimization of drugs and dosage to achieve the optimal outcomes for that individual patient. Tailoring therapy to achieve a desired neurohormonal response and improve outcomes has been demonstrated and further large-scale clinical trials are ongoing in this area. In the meanwhile we should ensure that evidence-based therapies are more widely applied in general to all patients with heart failure, continue to debate dosage while supporting additional more definitive studies. R. N. DOUGHTY N. SHARPE Division of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand References