What do systematic reviews say?

Angiotensin‐converting enzyme inhibitors vs placebo or no treatment

Angiotensin‐converting enzyme inhibitors (ACEIs) 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 0.93 [0.61, 1.42]
  2 studies · 945 participants
  Moderate

Angiotensin‐converting enzyme inhibitors vs placebo or no treatment

Angiotensin‐converting enzyme inhibitors (ACEIs) showed no clear difference in 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 0.86 [0.64, 1.15]
  3 studies · 1019 participants
  Moderate

Angiotensin‐converting enzyme inhibitors 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
  1 study · 74 participants
  Very low

Angiotensin‐converting enzyme inhibitors vs placebo or no treatment

Angiotensin‐converting enzyme inhibitors (ACEIs) showed no clear difference in all‐cause 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 1.04 [0.75, 1.45]
  5 studies · 1187 participants
  Moderate

Angiotensin‐converting enzyme inhibitors 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
  2 studies · 154 participants
  Low

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

Beta‐blockers vs placebo or no treatment

Beta‐blockers may leads to lower cardiovascular mortality (RR) compared with placebo or no treatment (low certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.78 [0.62, 0.99]
  3 studies · 1046 participants
  Low

Mineralocorticoid receptor antagonists (MRAs) 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 · 511 participants
  Low

Angiotensin receptor blockers (ARBs) vs placebo or no treatment

Angiotensin receptor blockers (ARBs) showed no clear difference in cardiovascular mortality (RR) 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 1.02 [0.9, 1.14]
  3 studies · 7254 participants
  High

Angiotensin receptor blockers (ARBs) vs placebo or no treatment

Angiotensin receptor blockers (ARBs) showed no clear difference in heart failure hospitalisation (RR) 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 0.92 [0.83, 1.02]
  3 studies · 7254 participants
  High

Angiotensin receptor blockers (ARBs) vs placebo or no treatment

Angiotensin receptor blockers (ARBs) 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 1.88 [1.07, 3.33]
  2 studies · 7148 participants
  High

Angiotensin receptor blockers (ARBs) vs placebo or no treatment

Angiotensin receptor blockers (ARBs) showed no clear difference in all‐cause mortality (RR) 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 1.01 [0.92, 1.11]
  4 studies · 7964 participants
  High

Beta‐blockers vs placebo or no treatment

It is very uncertain whether beta‐blockers changes heart failure hospitalisation (RR) compared with placebo or no treatment (very low certainty).

• Beta‐blockers and inhibitors of the renin‐angiotensin aldosterone system for chronic heart failure with preserved… 2021 · Cochrane Headline outcomes only
  RR 0.73 [0.47, 1.13]
  4 studies · 449 participants
  Very low

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

Beta‐blockers 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
  1 study · 245 participants
  Very low

Beta‐blockers vs placebo or no treatment

Beta‐blockers showed no clear difference in all‐cause mortality (RR) compared with placebo or no treatment (low 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 [0.67, 1]
  4 studies · 1105 participants
  Low