Not enough ACE inhibitors. Despite strong evidence that angiotensin-converting enzyme (ACE) inhibitors are beneficial in the treatment of heart failure, it appears that clinicians are not prescribing them as often as they should, according to a report in the August 10 issue of Circulation. Among a community-based sample of nearly 17,500 elderly patients with heart failure and left ventricular systolic dysfunction, only 68% were given ACE inhibitors at discharge. (When angiotensin-receptor blockers were added to the equation, the rate rose to 76%.) The rates of prescription were highest in the Northeast but none reached higher than 74%. Not incidentally, the mortality rates (crude and adjusted) at one year were significantly lower in the patients who received ACE inhibitors.