The Pivotal Role of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Hypertension Management and Cardiovascular and Renal Protection: A Critical Appraisal and Comparison of International Guidelines.

Coronary Syndromes In patients with stable CAD in the EUROPA study, the ACEi perindopril was associated with a 20% reduction in the relative risk of the primary endpoint (i.e., composite outcome of cardiovascular mortality, MI, or cardiac arrest with successful resuscitation) compared with placebo ( p = 0.0003); however, the reduction in the relative risks of cardiovascular mortality or all-cause mortality did not reach statistical significance [ 65 ].

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In a meta-analysis of 17 RCTs in 12,469 patients with symptomatic HF, ARBs showed a nonsignificant trend toward reducing the risk of mortality (OR 0.68, 95% CI 0.38–1.22) and hospitalization (OR 0.67, 95% CI 0.80–1.13) compared with placebo [ 79 ].

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