In diabetic patients with urinary ACR of at least 30 mg/24 h or in any adult, ACE inhibitors or ARBs are recommended, given the associated risk of hyperkalemia and AKI. Dual treatment with ACE inhibitors and ARB is usually avoided. Aldosterone receptor antagonists may also be considered for patients with albuminuria, refractory hypertension or heart failure with reduced ejection fraction. This evidence concerns the gene ACE and heart failure.