What do systematic reviews say?

Angiotensin receptor blockers (ARBs) vs placebo or no treatment

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 3117 participants
  High

Angiotensin receptor neprilysin inhibitors (ARNIs) vs usual care

Angiotensin receptor neprilysin inhibitors (ARNIs) showed no clear difference in cardiovascular mortality (RR) Median compared with usual care (moderate certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.96 [0.79, 1.15]
  1 study · 4796 participants
  Moderate

Angiotensin receptor neprilysin inhibitors (ARNIs) vs usual care

Angiotensin receptor neprilysin inhibitors (ARNIs) showed no clear difference in heart failure hospitalisation, first (RR) Range of compared with usual care (moderate certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.89 [0.8, 1]
  2 studies · 7362 participants
  Moderate

Angiotensin receptor neprilysin inhibitors (ARNIs) vs usual care

Angiotensin receptor neprilysin inhibitors (ARNIs) showed no clear difference in hyperkalaemia Range of compared with usual care (moderate certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.88 [0.77, 1.01]
  2 studies · 5054 participants
  Moderate

Angiotensin receptor neprilysin inhibitors (ARNIs) vs usual care

Angiotensin receptor neprilysin inhibitors (ARNIs) leads to lower all‐cause mortality (RR) Range of compared with usual care (high certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.97
  3 studies · 7663 participants
  High

Angiotensin receptor neprilysin inhibitors (ARNIs) vs usual care

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  no estimate extracted
  118 participants
  High

Mineralocorticoid receptor antagonists (MRAs) vs placebo or no treatment

Mineralocorticoid receptor antagonists (MRAs) showed no clear difference in cardiovascular mortality (RR) compared with placebo or no treatment (moderate certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.9 [0.74, 1.11]
  3 studies · 4070 participants
  Moderate

Mineralocorticoid receptor antagonists (MRAs) vs placebo or no treatment

Mineralocorticoid receptor antagonists (MRAs) probably leads to lower heart failure hospitalisation (RR) compared with placebo or no treatment (moderate certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.82 [0.69, 0.98]
  3 studies · 3714 participants
  Moderate

Mineralocorticoid receptor antagonists (MRAs) vs placebo or no treatment

Mineralocorticoid receptor antagonists (MRAs) leads to higher hyperkalaemia compared with placebo or no treatment (high certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 2.11 [1.77, 2.52]
  6 studies · 4291 participants
  High

Mineralocorticoid receptor antagonists (MRAs) vs placebo or no treatment

Mineralocorticoid receptor antagonists (MRAs) showed no clear difference in all‐cause mortality compared with placebo or no treatment (moderate certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.91 [0.78, 1.06]
  5 studies · 4207 participants
  Moderate