Update of REACH-1 and MERIT-HF clinical trials in heart failure. Cardio.net Editorial Team

Eur J Heart Fail. 1999 Jun;1(2):197-200. doi: 10.1016/s1388-9842(99)00022-7.


Background: This article reviews the design and results of REACH-1 (Research on Endothelin Antagonism in Chronic Heart Failure) and MERIT (Metoprolol controlled and Extended release, Randomised Intervention Trial in congestive Heart Failure), two recently reported clinical trials that investigated, respectively, the role of a non-selective endothelin antagonist (bosentan) and of a beta-selective blocker for the treatment of heart failure.

Results: The REACH-1 trial demonstrated that initiation of bosentan therapy is associated with an increased risk of worsening heart failure. However, long-term therapy with bosentan may have improved symptoms and favourably altered the progression of heart failure. The MERIT-HF clinical trial indicated that beta-blockade using metoprolol confers a significant beneficial effect on total mortality in patients with stable chronic heart failure.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use*
  • Bosentan
  • Double-Blind Method
  • Endothelins / antagonists & inhibitors
  • Europe / epidemiology
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Metoprolol / therapeutic use*
  • Middle Aged
  • Sulfonamides / therapeutic use*
  • Survival Rate
  • United States / epidemiology
  • Ventricular Function, Left / drug effects
  • Ventricular Function, Left / physiology*


  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Endothelins
  • Sulfonamides
  • Metoprolol
  • Bosentan