Key result
ACEI treatment significantly reduced all-cause mortality (RR 0.89; P=0.0008) in high-risk patients, whereas ARB treatment did not (RR 1.00; P=0.89).
Why the study?
Do ACEIs or ARBs reduce mortality, MI, and stroke in high-risk patients without heart failure compared to placebo?
Meta-Analysis (n=77,633)
Do ACEIs or ARBs reduce mortality, MI, and stroke in high-risk patients without heart failure compared to placebo?
Relative Risk: 0.89
p-value: p=0.0008
In high-risk patients without heart failure, ACE inhibitors reduce mortality, MI, and stroke, whereas ARBs only modestly reduce stroke without a mortality benefit.
No takes yet. Share an insight, caveat, or question.
ACEIs, but not ARBs, should be prioritized to lower mortality in high-risk patients without HF; challenges ARB equivalence assumptions in guidelines.
Ong et al. (2013) conducted a meta-analysis in High risk of cardiovascular events without heart failure (n=77,633). Angiotensin-converting enzyme inhibitors (ACEI) or Angiotensin-receptor blockers (ARB) vs. Placebo was evaluated on All cause mortality (RR 0.89, p=0.0008). ACEI treatment significantly reduced all-cause mortality (RR 0.89; P=0.0008) in high-risk patients, whereas ARB treatment did not (RR 1.00; P=0.89).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: