Related Experiment Video

Updated: Sep 30, 2026

Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model
10:18

Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model

Published on: June 29, 2014

Angiotensin converting enzyme inhibition in heart failure: clinical trials and clinical practice

lain B Squire1

  • 1Department of Medicine and Therapeutics, University of Leicester, UK. is11@le.ac.uk

Cardiovascular Drugs and Therapy
|June 28, 2002
PubMed

Insights

Angiotensin converting enzyme (ACE) inhibitors are effective heart failure treatments but are underused. Educating healthcare professionals can improve ACE inhibitor prescription rates for better patient outcomes.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure (HF) is a prevalent, debilitating condition with effective pharmacological treatments.
  • Angiotensin converting enzyme (ACE) inhibitors are a cornerstone therapy for HF, improving mortality and morbidity.

Purpose of the Study:

  • To address the underutilization of ACE inhibitors in heart failure management.
  • To highlight the gap between clinical trial evidence and routine practice regarding ACE inhibitor therapy.

Main Methods:

  • Review of clinical trial data on ACE inhibitor efficacy and adverse effects.
  • Analysis of factors influencing ACE inhibitor prescription rates in routine practice.

Main Results:

  • ACE inhibitors significantly improve mortality and morbidity in heart failure patients.
  • Physicians' perceptions of adverse effects (hypotension, renal impairment, cough) contribute to underutilization.
  • Prescription rates correlate with physician expertise and motivation, not solely patient factors.

Conclusions:

  • Despite proven benefits, ACE inhibitors are underprescribed in heart failure.
  • Education for healthcare professionals is crucial to optimize ACE inhibitor use in heart failure.
  • Addressing physician concerns and improving understanding of evidence can enhance therapy maximization.

Related Concept Videos

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...
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...
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
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...
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...
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...