Is combining ACE inhibitors and ARBs helpful or harmful?
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Combining angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) reduces admissions for heart failure in patients with congestive heart failure (CHF), but with an increased rate of adverse effects and no reduction in mortality or overall hospitalization rates (SOR: A, meta-analysis of RCTs). Combination therapy is not superior to monotherapy in preventing serious adverse outcomes in patients with known vascular disease or diabetes with end-organ damage and has higher rates of hypotension, diarrhea, and renal impairment (SOR: B, 1 RCT).
Evidence-based practice 16, no. 01 (2013): 08