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Published on: May 19, 2017
Cardioprotection and ACE inhibitors
1Dept. of Cardiovascular Studies, University of Leeds, England.
Insights
Angiotensin converting enzyme (ACE) inhibitors effectively lower blood pressure and manage heart failure. Ongoing trials are investigating their impact on reducing myocardial infarction consequences and prolonging life in heart failure patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Angiotensin converting enzyme (ACE) inhibitors are established treatments for hypertension and heart failure.
- Their efficacy in blood pressure reduction is comparable to other antihypertensive agents.
- Combined with diuretics, ACE inhibitors show potential to revolutionize chronic heart failure management.
Purpose of the Study:
- To evaluate the effectiveness of ACE inhibitors in reducing myocardial infarction rates and their consequences.
- To determine if ACE inhibitors prolong survival in patients with chronic heart failure and post-myocardial infarction.
Main Methods:
- Review of current clinical practices and ongoing major clinical trials (e.g., V-HeFT II, SOLVD, CONSENSUS II, SAVE, AIRE, GISSI III, ISIS IV).
- Analysis of pharmacological profiles of available ACE inhibitors.
Main Results:
- ACE inhibitors are effective in lowering blood pressure and managing chronic heart failure symptoms.
- Evidence is accumulating on their potential to reduce mortality in heart failure and post-myocardial infarction settings.
Conclusions:
- ACE inhibitors are valuable tools in managing hypertension and heart failure.
- Further results from ongoing trials are anticipated to clarify their role in reducing cardiovascular mortality.
- Physicians can select from various ACE inhibitors with distinct pharmacological profiles.
Abstract:
Angiotensin converting enzyme inhibitors are now widely used in the treatment of hypertension and heart failure. They are clearly as effective as other conventional antihypertensive agents in reducing blood pressure and combined with diuretics seem likely to transform current management of chronic heart failure. Myocardial infarction remains the major cause of death in patients with raised blood pressure and current studies should establish whether the attractive features of ACE inhibitors translate into reduction in the rate of infarction or its consequences. Similarly, whilst symptomatic benefit undoubtedly accrues from their use in heart failure it is less clear that they can prolong life particularly when used in the immediate setting of a myocardial infarction. Again a number of ongoing major trials are set to establish whether these drugs reduce death in patients with chronic heart failure (V-HeFT II, SOLVD) and in patients immediately after myocardial infarction (CONSENSUS II, SAVE,. AIRE, GISSI III and ISIS IV). The physician has a wide choice of ACE inhibitors with different pharmacological profiles for clinical use.
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