Heart failure is a common condition associated with substantial mortality, morbidity and impairment of quality of life. However, despite the proven efficacy of angiotensin-converting enzyme (ACE) inhibitors, heart failure is often under-diagnosed and under-treated, particularly in primary care. In some studies, for example, only about one-third of patients received ACE inhibitors, and at doses substantially lower than those shown to be effective in clinical trials. The major reason for under-...