Table 2. GRADE summary of findings.
Statistically significant results are shown in bold text.
| ACEIs | ARBs | BBs | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Outcome | Quality of evidence | Effect (follow-up range 3–58 months–mean 28 months) |
Certain assessment | Effect (follow-up range 3–66 months–mean 45 months) |
Certain assessment | Effect (follow-up range 3–36 months–mean 17 months) |
|||
| RR (95% CI) | Absolute change, per 1000 | RR (95% CI) | Absolute change, per 1000 | RR (95% CI) | Absolute change, per 1000 | ||||
| Mortality | |||||||||
| All-cause | MODERATE 1 | 0.94 (0.87 to 1.02) |
19 fewer (from 6 more to 40 fewer) |
MODERATE 1 | 0.96 (0.87 to 1.04) |
12 fewer (from 12 more to 40 fewer) |
LOW 2 | 0.25 (0.06 to 1.01) |
36 fewer (from 0 more to 45 fewer) |
| Cardiovascular | MODERATE 1 | 0.92 (0.85 to 1.01) |
30 fewer (from 4 more to 55 fewer) |
MODERATE 1 | 0.93 (0.83 to 1.04) |
17 fewer (from 10 more to 42 fewer) |
- | NR | NR |
| Hospitalization | |||||||||
| All-cause | MODERATE 1 | 0.94 (0.86 to 1.02) |
22 fewer (from 7 more to 52 fewer) |
MODERATE 1 | 0.98 (0.93 to 1.04) |
11 fewer (from 23 more to 40 fewer) |
LOW 2 | 0.93 (0.39 to 2.24) |
8 fewer (from 66 fewer to 134 more) |
| Heart failure | LOW 1 3 | 0.86 (0.56 to 1.32) |
18 fewer (from 42 more to 58 fewer) |
MODERATE 1 |
0.89 (0.80 to 0.99) |
28 fewer (from 3 to 52 fewer) |
LOW 2 | 2.48 (0.60 to 10.28) |
23 more (from 6 fewer to 143 more) |
| Heart failure worsening | HIGH |
0.85 (0.79 to 0.92) |
51 fewer (from 27 to 71 fewer) |
MODERATE 1 |
0.91 (0.84 to 0.99) |
32 fewer (from 4 to 57 fewer) |
LOW 2 | 0.45 (0.11 to 1.86) |
16 fewer (from 26 fewer to 26 more) |
| Adverse effects | |||||||||
| Leading to discontinuation | MODERATE 1 | 1.19 (0.97 to 1.46) |
13 more (from 2 fewer to 31 more) |
MODERATE 1 | 1.17 (0.94 to 1.45) |
11 more (from 4 fewer to 30 more) |
VERY LOW 2 4 | 1.98 (0.37 to 10.62) |
16 more (from 11 fewer to 162 more) |
| Hypotension | HIGH |
1.60 (1.28 to 2.00) |
30 more (from 14 to 51 more) |
HIGH |
1.40 (1.15 to 1.72) |
27 more (from 10 to 49 more) |
VERY LOW 2 4 | 1.12 (0.35 to 3.53) |
7 more (from 39 fewer to 152 more) |
| Dizziness | MODERATE 3 |
1.39 (1.22 to 1.59) |
51 more (from 29 to 77 more) |
- | NR | NR | LOW 1 4 |
1.59 (1.00 to 2.52) |
142 more (from 0 to 366 more) |
| Hyperkalemia | HIGH |
1.87 (1.39 to 2.51) |
24 more (from 11 to 42 more) |
MODERATE 4 |
1.48 (1.20 to 1.83) |
33 more (from 14 to 57 more) |
- | NR | NR |
| Serum creatinine increase | HIGH |
1.46 (1.18 to 1.81) |
27 more (from 10 to 47 more) |
HIGH |
1.41 (1.24 to 1.60) |
62 more (from 37 to 91 more) |
- | NR | NR |
| Cough | MODERATE 1 |
0.83 (0.71 to 0.97) |
23 fewer (from 4 to 39 fewer) |
- | NR | NR | - | NR | NR |
ACEI: Angiotensin-converting enzyme inhibitor, ARB: Angiotensin-2 receptor blocker, BB: beta-blocker, NR: Not reported.
1 Rated down 1 category for serious imprecision
2 Rated down 2 categories for very serious imprecision
3 Rated down 1 category for serious inconsistency
4 Rate down 1 category for suspected selective outcome reporting bias