In addition to this no evidence was identified for the interventions of loop diuretics; sacubitril-valsartan; or hydralazine-nitrate versus placebo. Furthermore, no inter or intra class comparisons were identified. ACE inhibitors: For the comparison of ACE inhibitors versus placebo the evidence was rated as very low quality and suggested a clinically important reduction in hospitalisations with ACE inhibitors (n=1036) (associated with wide confidence intervals around the effect estimate). For the outcomes renal function (n=967) and hyperkalemia (n=970) there was no clinical effect of ACE inhibitors. With high dose versus low dose ACE inhibitors all of the outcomes were again rated as very low quality. The outcomes renal dysfunction or hyperkalaemia (associated with wide confidence intervals around the effect estimate) and hypotension/dizziness all suggested a clinically important increase in events with high dose ACE inhibitors (n=988). Mortality did not demonstrate a clear effect with the confidence interval ranging from a decrease and increase in all-cause mortality. ARBs: For the comparison of ARB versus placebo the evidence was rated from low to very low quality. The evidence suggested a clinically important increase in hyperkalemia (n=3065) with ARBs. The composite outcome of CV mortality and HF admission (n=154) suggested a clinically important reduction in events with ARBs. This was also the case for the outcome morbid events which included hospitalisations and death (n=2917). For renal function there was no clinically important effect of ARBs on eGFR (n=2179) and zero events of renal failure or progression to dialysis were reported in a single study (n=2911). For the comparison of high dose ARBs with low dose the evidence was rated as very low quality and suggested a clinically important reduction in HF Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 hospitalisations (n=945). 