Study designs of evaluations included in the review
Blinded parallel-group randomised trials (RCTs) were eligible for inclusion. Crossover trials were excluded. All of the included studies were double-blind.
Specific interventions included in the review
Studies of ARBs versus placebo or angiotensin-convertingenzyme inhibitors (ACEIs) were eligible for inclusion if treatment was given for at least 4 weeks. Studies were excluded if other investigational agents were co-administered without randomisation. Various regimens of eprosartan, losartan, valsartan, candesartan and ibresartan were used in the included studies. The mean duration of treatment was 4 weeks to 1.5 years.
Participants included in the review
Studies in patients with heart failure of New York Heart Association functional class II to IV were eligible for inclusion. In the included studies, 2 to 15% of the patients were in functional class IV and the mean age of the participants ranged from 56 to 73 years.
Outcomes assessed in the review
Studies that reported mortality or hospitalisation were eligible for inclusion. The primary outcome was all-cause mortality and the secondary outcome was hospitalisation for heart failure. The latter was defined as admission for worsening signs and symptoms or complications related to the treatment of heart failure, or syncope or arrhythmias related to acute exacerbations of heart failure.
How were decisions on the relevance of primary studies made?
The authors stated that relevant studies were determined by consensus.