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Submitted: 02 September 2007 Modified: 09 May 2012
HERDIN Record #: PCHRD090107030932

Combination of angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker therapy in heart failure: A meta-analysis .

Felibert Dianco

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Background
Angiotensin Converting Enzyme (ACE) inhibitors increase survival when introduced at any stage of CHF. ACE inhibitors are believed to act principally by blocking the formation of angiotensin II that may contribute to increased impedance to left ventricular ejection and cardiac remodeling. However growing evidence supports an important role for non ACE mediated enzymatic pathways in the conversion of angiotensin I to A-II. The combination of Angiotensin Receptor blockers (ARBs) and ACEI has been reported to offer more complete blockade of the effect of angiotensin II than treatment with ACE alone.

Methods and Results
Data Source: Medline, Pubmed, Grateful med, and Cochrane controlled Trials Registry Study Selection: Randomized Controlled Studies on patients given with combination of Angiotensin-Converting enzyme Inhibitor (ACE) and Angiotensin II Receptor Blocker Therapy in Heart Failure. Collection and Analysis: Data were entered in the Cochrane Review Manager software. (Review Manager 4.2.7). Weighted Odds Ratio were calculated. Data Synthesis: Results showed trend toward the benefit for the combination of ACE plus ARB in the treatment of Heart failure but was not statistically significant. Adverse effects like hypotension, hyperkalemia and renal failure is more in the combination therapy.

Conclusion
There is a trend showing the benefit of the combination of ACE and ARB in the treatment of heart failure than monotherapy with ACE inhibitors. On the other hand, there is also a trend toward increase in adverse events like hypotension, renal impairment and hyperkalemia in the combination of ACE and ARB. (Author)

Publication Type
Journal
Publication Sub Type
Announcements
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
January-March 2006
Volume
12
Issue
1
Page(s)
41-47

Objectives

To determine the effect of the combination therapy of angiotensin converting enzyme inhibitor(ACE) and angiotensin 11 receptor blocker (ARB) therapy to monotherapy with angiotensin converting enzyme in the treatment of heart failure.

- To ascertain if there effect on the primary end point that, is cardiovascular death.

- To ascertain if there is effect on hospital admission due to heart failure and cardiovascular death, and death from congestive heart failure, myocardial infarction and stroke.

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)

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