Heart Failure - Use of ACE Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) Therapy

Contraindications to an ACEI or ARB, including:
- Hyperpotassemia
- Hypertrophic cardiomyopathy
- Aortic stenosis
- Hypotension
- Pregnancy
- Chronic kidney disease stage 3 and 4
- Chronic kidney disease stage 5 in the absence of dialysis
- Hydralazine after prior ACE-I/ARB use
- 20% increase in creatinine
- Aliskerin
- Multiple myeloma
- Patient data indicating that the member is planning pregnancy
Additional denominator exclusions:
- Heart transplant
- Pulmonary hypertension treatment
- Valve surgery
- Patient or provider feedback indicating allergy, intolerance or contraindication




General exclusions:
- Evidence of metastatic disease or active treatment of malignancy (chemotherapy or radiation therapy) in the last 6 months;
- Patients who have been in a skilled nursing facility in the last 3 months