Related Experiment Video

Updated: Aug 16, 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

Is optimal angiotensin-converting enzyme inhibitor dosing neglected in elderly patients with heart failure?

W A Gattis1, R L Larsen, V Hasselblad

  • 1Duke University Medical Center, Department of Medicine, and the Duke Clinical Research Institute, Durham, NC 27710, USA.

American Heart Journal
|July 17, 1998
PubMed

Insights

Elderly heart failure patients often receive lower doses of angiotensin-converting enzyme (ACE) inhibitors, increasing their risk for clinical events. Optimizing ACE inhibitor therapy in older adults is crucial for improved heart failure outcomes.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Angiotensin-converting enzyme (ACE) inhibitors are proven to reduce mortality in heart failure patients.
  • Despite proven benefits, ACE inhibitor utilization patterns require further investigation.

Purpose of the Study:

  • To compare ACE inhibitor prescribing patterns, specifically target doses, between elderly and nonelderly heart failure patients.
  • To identify potential disparities in ACE inhibitor utilization and their impact on clinical outcomes in different age groups.

Main Methods:

  • Prospective evaluation of 43 ambulatory heart failure patients.
  • Assessment of prescribed ACE inhibitor doses and clinical events via patient interviews and medical records.
  • Follow-up at 3 months to document clinical events.

Main Results:

  • Elderly patients were significantly less likely to receive target ACE inhibitor doses (21.4% vs. 68.8%, p=0.0136).
  • Elderly patients experienced more clinical events compared to nonelderly patients (11 vs. 4, p=0.0074).
  • A trend indicated higher event rates in elderly patients not at target ACE inhibitor doses.

Conclusions:

  • Lower ACE inhibitor doses in elderly heart failure patients may be associated with an increased risk of clinical events.
  • These findings highlight a potential gap in optimizing ACE inhibitor therapy for elderly heart failure populations.
Abstract

More Related Videos

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Related Concept Videos

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 Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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...
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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.