A new, direct angiotensin-II subtype 1 receptor antagonist, candesartan, was studied in the 60-center, international Randomized Evaluation of Strategies for Left Ventricular Dysfunction (RESOLVD) trial. The trial included two stages: one evaluated candesartan alone and candesartan with the addition of enalapril; the second stage evaluated doses of a beta-blocker, metopolol, which was titrated upward, compared with placebo. Both stages involved patients with congestive heart failure. The results of the first stage of the trial are presented, with a concentration on data obtained from the group of patients receiving combination therapy. Although the trial was too small to be sufficiently powerful to evaluate clinical outcomes, the results concerning the primary endpoints used are compared, and the differences between the three stage I combination treatment groups are discussed. Overall, the researchers concluded that candesartan has an effect similar to enalapril in patients with heart failure, who often demonstrate worsening symptoms and deterioration of ventricular function when treated with angiotensin converting enzyme (ACE) inhibitors alone. However, combination therapy performed better than either drug alone when certain endpoints were analyzed.