Why the study?
Does combination Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker therapy improve outcomes compared to monotherapy in patients with hypertension, heart failure, or kidney disease?
Does combination Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker therapy improve outcomes compared to monotherapy in patients with hypertension, heart failure, or kidney disease?
Current evidence is insufficient to support the routine clinical use of combined ACE inhibitor and ARB therapy.
Does not support routine combination ACE inhibitor and ARB therapy; leaves open the need for definitive RCTs in hypertension, HF, and CKD.
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are commonly prescribed for the management of hypertension. In addition, each of these drug classes has been shown to be effective in the treatment of congestive heart failure, proteinuric chronic kidney disease, and most recently the high-cardiac-risk profile patient. The individual success of each of these drug classes has fueled the theory that given together, the overall biologic effect of both would surpass that of either given alone. The foundation of this premise, although biologically plausible, has yet to be proven in a compelling enough fashion to support the everyday use of these two drug classes in combination. Additional clarifying studies are required to establish whether specific patient subsets exist that might benefit from such combination therapy.
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Domenic A. Sica (2003) studied this question.
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