What are Class I recommendations for Inhibitors of the Renin-Angiotensin- Aldosterone System?
Class I recommendations for Inhibitors of the Renin-Angiotensin- Aldosterone System include ACE inhibitors should be started and continued indefinitely in all patients with LVEF less than 0.40 and in those with hypertension, diabetes mellitus, or stable CKD (Section 7.6), unless contraindicated; ARBs are recommended in patients with HF or MI with LVEF less than 0.40 who are ACE inhibitor in; and Aldosterone blockade is recommended in patients post MI without significant renal dysfunction (creatinine >2.5 mg/dL in men or >2.0 mg/dL in women) or hyperkalemia (K+ >5.0 mEq/L) who are receiving therapeutic doses of ACE inhibitor and beta blocker and have a LVEF 0.40 or less, diabetes mellitus. All recommendations have a Level of Evidence rating of A.