Objective To evaluate the therapeutic effects of double dosage of perindopril and candesartan in the elderly heart failure (HF) patients with degenerative valvular disease.Methods A total of 218 elderly HF patients with degenerative valvular disease were divided into three groups: perindopril group,candesartan group,and control group.In perindopril group,the patients received 2-week perindopril treatment at daily dosage of 4mg,then the dosage changed to 8mg.In candesartan group,the treatment regimen was similar to that in perindopril group,except that perindopril was replaced by candesartan.In control group,the patients received routine treatment.After 24-week treatment,the adverse reactions,serum high sensitivity C-reactive protein (hsCRP),brain natriuretic peptide (BNP),and left ventricular mass index (LVMI) were determined.Results The serum hsCRP,BNP and LVMI decreased significantly in perindopril group (P<0.05).In candesartan group,the serum LVMI and BNP decreased,but with no significance (P>0.05),while serum hsCRP decreased significantly (P<0.05).The effectiveness rate was 84.9%,69.3%,and 52% in perindopril,candesartan,and control groups,respectively,with significant difference among 3 groups (P<0.05).The adverse reaction was most obvious in perindopril group (15.1%),among which,coughing incidence accounted for 6.5%.The Lower limb edema was the most obvious in control group (6%,P<0.05).Conclusion Both perindopril and candesartan can alleviate left ventricular hypertrophy and afford good tolerance to the elderly HF patients with degenerative valvular disease.