ACE and hydrops fetalis: For example, a meta-analysis of 12 763 patients with HFrEF demonstrated that ACE inhibitors significantly reduce total mortality, as well as lower rates of readmission for HF and lower incidence of MI.86 In addition, several clinical trials showed that ARB therapy also reduced mortality and hospitalization in patients with HF.87,88 However, the effects are mostly smaller than the ones observed for ACE inhibitors although ARBs are generally better tolerated.