Patients treated with combination therapy had a higher risk of worsening renal function than patients treated with ACE inhibitor therapy alone (RR 1.91, 95%CI 1.40–2.60, p-value for heterogeneity = 0.12; I2 = 46% [95%CI 0–80%]), symptomatic hypotension (RR 1.57, 95%CI 1.44–1.71, p-value for heterogeneity = 0.99; I2 = 0%[95%CI 0–79%]) and an increased risk of developing hyperkalemia (RR 1.95, 95%CI 0.85–4.48, p-value for heterogeneity = 0.007; I2 = 75%[95%CI 31–91%]). Here, ACE is linked to Hyperkalemia.