An 84-Year-Old Man Comes to the Physician with Persistent Dyspnea

question 1086

Multiple Choice

An 84-year-old man comes to the physician with persistent dyspnea despite being treated with optimal medical therapy for congestive heart failure with low left ventricular ejection fraction.  A recently published randomized clinical trial compared an angiotensin-neprilysin inhibitor (ANi) to an angiotensin-converting enzyme inhibitor (ACEi) in patients who have heart failure with a reduced ejection fraction.  The following results were reported:
Which of the following would be of most concern when switching from an ACEi to an ANi?

• A)Dangerous hyperkalemia
• B)Increased hospitalizations for heart failure
• C)Uncomfortable cough
• D)Unsafe drop in blood pressure
• E)Worsening renal function

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Definitions:

Randomization

The process of making choices randomly (or as if by chance), often used in experiments to eliminate bias and ensure an unbiased distribution of experimental conditions.

Repetition

The act or an instance of repeating something, often for emphasis, learning or effect.

Sampling Method

The technique or process used to select a sample from a population for statistical analysis.

Stratified Sample

A stratified sample involves dividing a population into smaller groups, or strata, and randomly sampling from each stratum to ensure representation of all groups.