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Review: angiotensin receptor blockers do not reduce mortality or hospital admission rates in heart failure

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 QUESTION: In patients with heart failure (HF), do angiotensin receptor blockers (ARBs) reduce mortality and hospital admission rates?

Data sources

Studies were identified by searching Medline, EMBASE/Excerpta Medica, Biological Abstracts, International Pharmaceutical Abstracts, Cochrane Controlled Trials Database, McMaster Cardiovascular Randomized Clinical Trial Registry, and Science Citation Index up to May 2001.

Study selection

Studies were selected if they were randomised controlled trials with blinding and at least 4 weeks of follow up that compared ARBs with either placebo or angiotensin converting enzyme inhibitors (ACEIs) in patients with New York Heart Association functional class II to IV HF and if they reported on mortality and hospital admission rates. Studies reported in non-peer reviewed journals were excluded.

Data extraction

Data were extracted independently by 2 reviewers on patient characteristics, drug type and dose, mean follow up, and outcomes.

Main results

17 trials (12 469 …

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  • Sources of funding: Heart and Stroke Foundation of Ontario; Canadian Institutes of Health Research.

  • For correspondence: Dr P Liu, Heart & Stroke/Richard Lewar Centre of Excellence, Toronto, Ontario, Canada. peter.liu{at}