Last reviewed 01/2018

This multicentre, randomised, double-blind, parellel-group trial enrolled 3000 patients with chronic heart failure and an ejection fraction of <30%.

The aim of the trial was to determine whether a high or low dose of lisinopril is optimal in prolonging the life of patients with heart failure.


  • there was no significant difference between the groups (low dose lisinopril, high dose lisinopril) for all cause mortality or cardiovascular mortality
  • however high dose lisinopril was more effective than low dose lisinopril for reducing the combined endpoints of all cause mortality combined with either cardiovascular admissions to hospital, congestive heart failure admissions to hospital, or all admissions to hospital. Also the high dose group had lower rates of cardiovascular mortality plus cardiovascular admissions to hospital


  • (1) Packer M, Poole-Wilson PA, Armstrong PW, et al, on behalf of the ATLAS Study Group (1999). Comparative effects of low and high doses of angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. Circulation, 100, 2312-8.