This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
AHRQ Releases New Guides on Coronary Heart Disease
Documents Summarize Risks, Benefits of ARBs, ACEIs
By News Staff
The guides are based on information from a comparative effectiveness review (170-page PDF; About PDFs) prepared last year by the University of Connecticut/Hartford Hospital Evidence-based Practice Center.
The "Clinical Bottom Line" section of the clinician guide lists the following findings:
- Adding an ACEI to standard treatment reduces total mortality, as well as the incidences of nonfatal myocardial infarction, heart failure-related hospitalization and revascularization. However, the addition of an ACEI also increases the risk of syncope, cough and hyperkalemia.
- Adding an ARB to standard treatment for patients who cannot tolerate ACEIs reduces the combined end points of cardiovascular mortality, nonfatal myocardial infarction and stroke, but it increases the risk of hyperkalemia.
- Adding both an ACEI and an ARB to standard treatment provides no additional clinical benefit compared with adding an ACEI alone, and it increases the risk of hypotension, sudden fainting and renal impairment.
- Adding an ACEI or an ARB to standard treatment in a patient who is soon to undergo a revascularization procedure provides no additional clinical benefit compared with standard therapy alone and increases the risk of subsequent revascularizations and hypotension.