ACE and Stroke: Both (VALIANT) and (ONTARGET) trials revealed that concurrent use of both ACE inhibitors and ARBs was not associated with reduce the risk of death from cardiovascular causes, myocardial infarction, stroke or hospitalization from heart failure but had significantly increased risk of hypotension, syncope, renal dysfunction, and hyperkalemia, with a trend toward an increased risk of renal dysfunction requiring dialysis.32, 33