{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:46:23Z","timestamp":1790063183419,"version":"4.0.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":3059,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T00:00:00Z","timestamp":1504483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Studies with angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) in patients with heart failure with preserved ejection fraction (HFpEF) have yielded inconsistent results. To conduct a systematic review and meta-analysis of all evidence for ACE-I and ARBs in patients with HFpEF, we searched PubMed, Ovid SP, Embase, and Cochrane database to identify randomized trials and observational studies that compared ACE-I or ARBs against placebo or standard therapy in HFpEF patients. Random-effect models were used to pool the data, and I2 testing was performed to assess the heterogeneity of the included studies. A total of 13 studies (treatment arm = 8676 and control arm = 8608) were analysed. Pooled analysis of randomized trials for ACE-I and ARBs (n = 6) did not show any effect on all-cause mortality [relative risk (RR) = 1.02, 95% confidence interval (CI) = 0.93\u20131.11, P = 0.68, I2 = 0%], while results from observational studies showed a significant improvement (RR = 0.91, 95% CI = 0.87\u20130.95, P = 0.005, I2 = 81.5%). In pooled analyses of all studies, ACE-I showed a reduction of all-cause mortality (RR = 0.91, 95% CI = 0.87\u20130.95, P = 0.01). There was no reduction in cardiovascular mortality seen, but in pooled analysis of randomized trials, there was a trend towards reduced HF hospitalization risk (RR = 0.91, 95% CI = 0.83\u20131.01, I2 = 0%, P = 0.074). These data suggest that ACE-I and ARBs may have a role in improving outcomes of patients with HFpEF, underscoring the need for future research with careful patient selection, and trial design and conduct.<\/jats:p>","DOI":"10.1002\/ehf2.12204","type":"journal-article","created":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T06:22:40Z","timestamp":1504506160000},"page":"402-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Renin\u2013Angiotensin Blockade in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"4","author":[{"given":"Muhammad Shahzeb","family":"Khan","sequence":"first","affiliation":[{"name":"John H. Stroger Jr, Hospital of Cook County , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, University of California Los Angeles , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Khan","sequence":"additional","affiliation":[{"name":"Cardiology Division, Emory University School of Medicine , Atlanta, GA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Cardiology Division, Duke University Medical Center , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Center G\u00f6ttingen (UMG) , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Gheorghiade","sequence":"additional","affiliation":[{"name":"Cardiology Division, Northwestern University Feinberg School of Medicine , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Cardiology Division, Stony Brook School of Medicine , Stony Brook, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,9,4]]},"reference":[{"key":"2026012115152879600_ehf212204-bib-0001","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.pcad.2005.02.010","article-title":"Epidemiology of diastolic heart failure","volume":"47","author":"Owan","year":"2005","journal-title":"Prog Cardiovasc 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