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[ACE inhibitor or ATII receptor blocker in heart failure and myocardial infarction?]
Knud Landmark1, Asmund Reikvam
1Institutt for farmakoterapi, Postboks 1065 Blindern, 0316 Oslo. k.h.landmark@labmed.uio.no
Abstract:
Angiotensin converting enzyme (ACE) inhibitors are important drugs in the treatment of hypertension, heart failure and after acute myocardial infarction. The patents for most of these agents have now expired and the industry has introduced angiotensin II receptor blockers (ATII receptor blockers) with a mode of action similar to that of ACE inhibitors. All six ATII receptor blockers on the Norwegian market have the indication hypertension, while one of them also has the indication heart failure when treatment with ACE inhibitors is not appropriate. Some studies have compared ACE inhibitors with ATII receptor blockers in the treatment of heart failure and after acute myocardial infarction and found the two classes of drugs to be about equally efficacious. There is no reason to change the current practice of choosing ACE inhibitors as first line treatment for these conditions. If ACE inhibitors cannot be used, ATII receptor blockers represent an acceptable alternative.
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