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Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and/or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Patients With Stable Ischemic Heart Disease and Preserved Left Ventricular Systolic Function

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Guidelines for the Use of ACEIs, ARBs, or Both to Treat Patients With Cardiac Disease (1)

A closer look at the current American College of Cardiology and American Heart Association guidelines reveals that angiotensin-converting enzyme inhibitors (ACEIs) are indicated for patients who have chronic heart failure or myocardial infarction and left ventricular dysfunction, which is defined as a left ventricular ejection fraction ≤40%. Angiotensin II receptor blockers (ARBs) are reserved for patients who cannot tolerate ACEIs. In patients with heart failure, combining an ACEI with an ARB has been shown to provide additional benefits over an ACEI alone. However, it is unclear if ACEIs or ARBs impact the risk of future cardiovascular events in patients without left ventricular systolic dysfunction (LVSD).