However, it is different from the VAL-HEFT and CHARM studies, which also examined the combination of an ACE inhibitor with an ARB {2,3}. The latter two trials showed an added benefit from the combination therapy, but they examined different patient populations (congestive heart failure) and their design did not stress an increase in the dose of ACE inhibitor to a maximum, which could account for the differences in their results. Questions also remain about the benefits of ACE inhibitor-ARB combination therapy in patients with established chronic kidney disease, given the benefits described in earlier (albeit much smaller) clinical trials and about the role of novel renin-inhibitor aliskiren. References: {1} Anderson et al., Am Heart J 2008, 155:706-711 [PMID:18371480]; {2} Krum et al., Eur J Heart Fail 2004, 6:937-945 [PMID:15556056]; {3} Pfeffer et al., Lancet 2003, 362:759-766 [PMID:13678868]. Trial registration: NCT00153101.