[Angiotensin-converting enzyme inhibition and cardiovascular prevention: more than twenty years of clinical success].

Abstract

Angiotensin-converting enzyme (ACE) inhibitors are widely used for the treatment of cardiovascular disease since they improve blood pressure control in patients with hypertension and prolong survival in patients with acute myocardial infarction, asymptomatic left ventricular dysfunction and congestive heart failure. Most of the information about the therapeutic role of ACE-inhibitors has been achieved during the last 20 years since the publication of some pivotal trials mostly involving the use of ACE-inhibitors like captopril and enalapril. In particular the treatment with enalapril has considerably improved the clinical outcome of patients with either mild-to-moderate (SOLVD studies) or severe (CONSENSUS trial) congestive heart failure. The benefit of ACE-inhibitors in patients with congestive heart failure has also involved a remarkable reduction in the rate of hospitalization, thus contributing to improve the pharmaco-economic approach to the disease. Most of the beneficial effect of ACE-inhibitors in clinical practice is dependent on their capacity of inhibiting the renin-angiotensin system, although some recent trials have supported a primary role for such drugs (in particular enalapril) in the prevention of atrial fibrillation. After more than 25 years from their discovery, ACE-inhibitors must be again considered among the first-line treatment in many patients with cardiovascular disease.

• Authors: Claudio Borghi, Eugenio Cosentino, Davide De Sanctis
• Journal: Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology (Ital Heart J Suppl) Vol. 6 Issue 12 Pg. 769-79 (Dec 2005) ISSN: 1129-4728 [Print] Italy
• Vernacular Title: Il ruolo dell'inibizione dell'enzima di conversione dell'angiotensina nella prevenzione cardiovascolare: oltre venti anni, ma non li dimostra.
• PMID: 16444921 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Enalapril
• Captopril

Topics

• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Atrial Fibrillation (prevention & control)
• Captopril (therapeutic use)
• Cardiovascular Diseases (drug therapy, prevention & control)
• Enalapril (therapeutic use)
• Heart Failure (drug therapy)
• Humans
• Hypertension (drug therapy)
• Myocardial Infarction (prevention & control)
• Myocardial Ischemia (drug therapy)
• Renin-Angiotensin System (drug effects)
• Ventricular Dysfunction (drug therapy)