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Published on: May 26, 2022

Role and optimal dosing of angiotensin-converting enzyme inhibitors in heart failure

Dhruv Kazi1, Anita Deswal

  • 1Division of Cardiology, University of California, 200 W Arbor Drive, MPF 360, San Diego, CA 92103, USA.

Cardiology Clinics
|March 4, 2008
PubMed

Insights

Angiotensin-converting enzyme (ACE) inhibitors are crucial for treating heart failure with reduced ejection fraction, improving outcomes. Their benefit in heart failure with preserved ejection fraction remains unproven, necessitating careful patient selection.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Angiotensin-converting enzyme (ACE) inhibitors are widely used for symptomatic left ventricular systolic dysfunction.
  • Evidence suggests potential benefits in preventing heart failure in high-risk individuals.

Purpose of the Study:

  • To evaluate the role of ACE inhibitors in heart failure management.
  • To clarify their efficacy in different heart failure subtypes.

Main Methods:

  • Review of clinical trial data on ACE inhibitor use in heart failure.
  • Analysis of outcomes related to morbidity and mortality.

Main Results:

  • ACE inhibitors significantly reduce morbidity and mortality in symptomatic systolic dysfunction.
  • Definitive benefits are not established for heart failure with preserved ejection fraction.
  • Specific ACE inhibitors (captopril, enalapril, lisinopril, ramipril) have proven efficacy.

Conclusions:

  • ACE inhibitors are a cornerstone therapy for heart failure with reduced ejection fraction.
  • Target doses demonstrated in trials should be pursued if tolerated.
  • Further research is needed for heart failure with preserved ejection fraction.

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