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Using ACE inhibitors appropriately

Daphne P Bicket1

  • 1Family Practice Residency Program, University of Pittsburgh Medical Center-McKeesport, Pennsylvania 15132, USA. bicketdp@msx.upmc.edu

American Family Physician
|August 17, 2002
PubMed

Insights

Angiotensin-converting enzyme (ACE) inhibitors, initially for hypertension, now treat heart failure, diabetes, and kidney disease by blocking the renin-angiotensin-aldosterone system. These drugs reduce cardiovascular events and are well-tolerated.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Angiotensin-converting enzyme (ACE) inhibitors were first approved for hypertension in 1981.
  • Their therapeutic applications have since expanded significantly due to their impact on the renin-angiotensin-aldosterone system.

Purpose of the Study:

  • To review the expanded indications and clinical outcomes of ACE inhibitors.
  • To highlight their role in managing cardiovascular and renal diseases.

Main Methods:

  • Review of clinical outcomes and established indications for ACE inhibitors.
  • Analysis of the pathophysiological mechanisms targeted by ACE inhibitors.

Main Results:

  • ACE inhibitors reduce morbidity and mortality in conditions including congestive heart failure, myocardial infarction, diabetes, and chronic renal insufficiency.
  • They attenuate the effects of Angiotensin II, such as endothelial dysfunction, altered renal hemodynamics, and cardiac hypertrophy.
  • Clinical outcomes include reduced rates of myocardial infarction, stroke, end-stage renal disease, and heart failure mortality.

Conclusions:

  • ACE inhibitors are effective in a wide range of cardiovascular and renal conditions.
  • They offer significant benefits by mitigating the detrimental effects of the renin-angiotensin-aldosterone system.
  • ACE inhibitors are generally well-tolerated with a favorable safety profile.

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