Table 2

 Safety outcomes between different drug combinations for dual blockade of the renin-angiotensin system (RAS) compared with monotherapy

RAS blocker combination v. monotherapyRelative risk (95% CI), P valueInteraction P value
ACE inhibitors+angiotensin receptor blockers:ACE inhibitorsAngiotensin receptor blockers
 Hyperkalaemia1.83 (1.35 to 2.50), 0.00011.34 (0.86 to 2.09), 0.190.26
 Hypotension2.02 (1.46 to 2.80), <0.0011.44 (1.04 to 2.01), 0.030.15
 Renal failure1.55 (1.23 to 1.96), 0.00021.15 (0.92 to 1.43), 0.220.07
 Withdrawal owing to drug related adverse events1.21 (1.16 to 1.26), <0.0011.39 (1.14 to 1.70), 0.0010.18
ACE inhibitors+aliskiren:ACE inhibitorsAliskiren
 Hyperkalaemia1.70 (1.11 to 2.58), 0.012.55 (1.00 to 6.46), 0.050.44
 Hypotension1.97 (1.17 to 3.30), 0.02No studies availableNA
 Renal failure1.75 (0.92 to 3.34), 0.090.34 (0.04 to 3.24), 0.350.16
 Withdrawal owing to drug related adverse events0.97 (0.34 to 2.74), 0.950.56 (0.21 to 1.48), 0.240.45
Angiotensin receptor blockers+aliskiren:Angiotensin receptor blockersAliskiren
 Hyperkalaemia1.40 (1.02 to 1.91), 0.041.49 (0.83 to 2.68), 0.180.86
 Hypotension1.62 (0.70 to 3.74), 0.261.02 (0.66 to 1.56), 0.940.34
 Renal failure1.13 (0.52 to 2.47), 0.761.02 (0.36 to 2.93), 0.970.88
 Withdrawal owing to drug related adverse events1.06 (0.79 to 1.43), 0.701.19 (0.54 to 2.66), 0.670.79

ACE=angiotensin converting enzyme; NA=not applicable.