[Effect of angiotensin-converting enzyme inhibitors in congestive heart failure]

Angiotensin-converting enzyme (ACE) inhibitors, in conjunction with diuretic agents, have an established role in the management of moderate and severe heart failure due to left ventricular dysfunction. ACE inhibitor improves prognosis, symptoms and exercise performance. There have been some promising studies and one of the most widely quoted is the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS I), which demonstrated a 36% reduction in mortality with the ACE inhibitor, enalapril, versus placebo in patients with advanced heart failure. Over the last few years, we have received important information that seems to tell us that ACE inhibitors must be utilized if we hope to reduce mortality. An important topic is study the action of ACE inhibitors in improving prognosis, and the mechanism of the action.