Related Experiment Video

Updated: Aug 29, 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 inhibitors in congestive heart failure: clinical practice guidelines]

Nathalie Thilly1, Faïez Zannad, Edith Dufay

  • 1Service d'Epidémiologie et Evaluation Cliniques (UPRES EA1124), Hôpital Marin, CHU Nancy, Nancy, France. n.thilly@chu-nancy.fr

Therapie
|December 19, 2003
PubMed

Insights

Angiotensin-converting enzyme (ACE) inhibitors are crucial for heart failure but underused. This study outlines clinical practice guidelines to improve their appropriate use in cardiology, addressing indications, dosages, and adverse effects.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Practice Guidelines

Context:

  • Underutilization of Angiotensin-converting enzyme (ACE) inhibitors in clinical cardiology practice.
  • Lack of specific consensus conferences on ACE inhibitor therapeutic strategies.
  • Need for standardized guidance in managing systolic heart failure.

Purpose:

  • To develop clinical practice guidelines for the management of systolic heart failure using ACE inhibitors.
  • To address the underutilization of ACE inhibitors by providing clear therapeutic strategies.
  • To standardize the approach to ACE inhibitor therapy in a specific region.

Summary:

  • Seventeen guidelines were formulated by hospital cardiologists using literature analysis and expert opinions.
  • Guidelines cover ACE inhibitor indications, contraindications, dosages, monitoring, adverse effects, and concomitant therapies.
  • A standardized procedure combining literature review and expert consensus was employed.

Impact:

  • Establishment of the first clinical practice guidelines for ACE inhibitor use in systolic heart failure in Lorraine.
  • Initiation of a quality improvement program in regional cardiology wards.
  • Potential to improve the appropriate utilization of evidence-based therapies for heart failure.

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...
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 VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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,...
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...