Am Fam Physician. 2012;86(12):1096a
Unclear statements about effectiveness of ACE inhibitors and angiotensin II receptor blockers. The Clinical Evidence Handbook (July 15, 2012, p. 182) contained two statements about the combination of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers that could have been more clear about which populations were being discussed. The first statement, “Combined treatment with angiotensin II receptor blockers and ACE inhibitors may lead to a greater reduction in hospital admissions for heart failure compared with ACE inhibitor treatment alone” (p. 182), refers to patients who already have a heart failure diagnosis. The second statement, “The combination of angiotensin II receptor blockers and ACE inhibitors seems no more effective than ACE inhibitors alone and causes more adverse effects” (p. 182), refers to persons with asymptomatic left ventricular systolic dysfunction or risk factors for heart failure who do not have a heart failure diagnosis.