Back to Archived Journals » Comparative Effectiveness Research » Volume 3

Angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers: do future research needs differ across disease states?

Authors Crowley M, Powers B, Myers E, McCrory D, McBroom A, Sanders G

Received 30 October 2012

Accepted for publication 1 December 2012

Published 10 January 2013 Volume 2013:3 Pages 1—9


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Matthew J Crowley,1,2 Benjamin J Powers,1,2 Evan R Myers,1,3 Douglas C McCrory,1 Amanda J McBroom,1 Gillian D Sanders1

1Duke Evidence-Based Practice Center, Duke Clinical Research Institute, 2Center for Health Service Research, Durham VA Medical Center, 3Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA

Background: The purpose of this study was to compare the findings of two Agency for Healthcare Research and Quality (AHRQ) future research need prioritization projects: 1) future research needs pertaining to comparative effectiveness of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin-II receptor blockers (ARB) in ischemic heart disease (IHD); and 2) future research needs pertaining to comparative effectiveness of ACE-I/ARB in hypertension.
Methods: Each of the two future research need prioritization projects was based on an AHRQ-sponsored comparative effectiveness review. For each project, we worked with the authors of the corresponding comparative effectiveness review to identify evidence gaps pertaining to the comparative effectiveness of ACE-I/ARB in the target condition, and performed an update of each review's literature search strategy. We then formed a distinct stakeholder group for each future research need prioritization project and engaged each group in sequential exercises to rank the identified evidence gaps.
Results: Although these projects engaged distinct stakeholder groups and relied upon different evidence bases, we noted near-complete overlap between the highest priority evidence gaps identified for each project. Stakeholders prioritized research: facilitating tailored treatment based on patient characteristics (eg, impact of demographics and comorbidities on ACE-I/ARB effectiveness); targeting optimal implementation of ACE-I/ARB among patients most likely to benefit (eg, studies to improve evidence-based use, treatment adherence, and quality of life with ACE-I/ARB); and examining the impact of ACE-I/ARB on the incidence of new cardiovascular/metabolic diagnoses.
Conclusion: Designing studies to address high priority evidence gaps for multiple disease conditions simultaneously may facilitate future comparisons of ACE-I/ARB, and may likewise be an appropriate strategy to improve research efficiency in other comparative effectiveness research scenarios.

Keywords: comparative effectiveness research, future research needs, hypertension, ischemic heart disease

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]