Table 7.

Expert guidelines regarding ACEI/ARB combination

CHEP recommendations 2009	Therapy using the combination of an ACE inhibitor and an ARB should only be considered in selected and closely monitored people with advanced heart failure or proteinuric nephropathy.
Canadian Cardiovascular Society Consensus 2009	ARBs should be added to an ACE inhibitor for patients with persistent HF symptoms despite optimal treatment with other recommended drugs.
ACC/AHA guideline 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults	The addition of an ARB may be considered in persistently symptomatic patients with reduced LVEF who are already being treated with conventional therapy.
ESC Guidelines for Diagnosis and Treatment for Acute or Chronic Heart Failure 2008	Unless contraindicated or not tolerated, ARB is recommended in patients with HF and LVEF < 40% who remain symptomatic despite optimal treatment with ACEI or beta blocker.
K/DOQI Clinical Practice Guidelines on Hypertension and Anti-hypertensive Agents in Chronic Kidney Disease 2004	ACE inhibitors and ARBs can be used in combination to lower blood pressure or reduce proteinuria.