Summary: For patients with chronic heart failure, treatment with enalapril (plus other standard heart-failure medications) appears to be associated with the same risk of cardiovascular death or heart-failure related hospital admission as treatment with aliskiren or treatment with aliskiren + enalapril, however treatment with aliskiren appears to be associated with higher rates of adverse events (specifically, renal dysfunction and hyperkalemia).

http://www.ncbi.nlm.nih.gov/m/pubmed/27043774/

Strength of Recommendation = B

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