Related Experiment Video

Updated: Jul 16, 2026

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview

M D Flather1, S Yusuf, L Køber

  • 1Preventive Cardiology and Therapeutic Research Program, Hamilton Health Sciences Corporation Research Centre, McMaster University, Ontario, Canada.

Lancet (London, England)
|May 23, 2000
PubMed

Insights

Angiotensin-converting enzyme (ACE) inhibitors significantly reduce mortality and hospital readmissions in patients with heart failure or left-ventricular dysfunction. These benefits, observed early and long-term, apply across diverse patient groups.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Prospective systematic overview of individual patient data from five long-term randomized trials.
  • Focus on angiotensin-converting enzyme (ACE) inhibitors for left-ventricular dysfunction or heart failure.

Purpose of the Study:

  • To evaluate the efficacy of ACE inhibitors in reducing mortality and morbidity in patients with left-ventricular dysfunction or heart failure.

Main Methods:

  • Meta-analysis of individual patient data from 12,763 participants across five randomized trials.
  • Peto-Yusuf method used for data combination.
  • Trials included patients within one week post-myocardial infarction and those with heart failure.

Main Results:

  • ACE inhibitors significantly reduced mortality (23.0% vs 26.8%) and reinfarction (8.9% vs 11.0%) across all trials.
  • Reduced rates of heart failure readmission (13.7% vs 18.9%) and composite events (33.8% vs 41.0%) were observed.
  • Benefits were consistent regardless of age, sex, or concomitant medications, and persisted long-term.

Conclusions:

  • ACE inhibitors are highly effective in improving outcomes for patients with left-ventricular dysfunction and heart failure.
  • Early and sustained benefits suggest ACE inhibitors as a cornerstone therapy in cardiovascular disease management.
Abstract

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration07:59

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Published on: April 4, 2022

Related Concept Videos

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...