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Angiotensin-converting enzyme inhibitor meta-analysis provides misleading conclusion

      Angeli et al
      • Angeli F
      • Verdecchia P
      • Reboldi G.P
      • Gattobigio R
      • Bentivoglio M
      • Staessen J.A
      • Porcellati C
      Meta-analysis of effectiveness or lack thereof of angiotensin-converting enzyme inhibitors for prevention of heart failure in patients with systemic hypertension.
      recently published a meta-analysis of the effects of angiotensin-converting enzyme (ACE) inhibitors versus all other drugs for the prevention of congestive heart failure in patients with systemic hypertension. For each trial, the authors combined the events in all non-ACE control groups regardless of the antihypertensive treatments patients in those groups received and compared this event rate with the event rate in the ACE inhibitor arm. Then, they calculated a pooled estimate of the effects of ACE inhibitors versus all other antihypertensive agents. This procedure assumes that all other agents are equal compared with ACE inhibitors. In other words, that they are all uniformly better, worse, or no different than ACE inhibitors.
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      References

        • Angeli F
        • Verdecchia P
        • Reboldi G.P
        • Gattobigio R
        • Bentivoglio M
        • Staessen J.A
        • Porcellati C
        Meta-analysis of effectiveness or lack thereof of angiotensin-converting enzyme inhibitors for prevention of heart failure in patients with systemic hypertension.
        Am J Cardiol. 2004; 93: 240-243