Modern treatment of patients at risk: still a HOPE for ACE inhibitors?

Abstract

Indications for angiotensin-converting enzyme (ACE) inhibitors include heart failure, postmyocardial infarction, diabetes mellitus and proteinuric chronic renal disease. ACE inhibitors provided life-saving benefits in patients with heart failure or left ventricular systolic dysfunction. On the other hand, there are conflicting data regarding the ability of ACE inhibitors to reduce the incidence of cardiovascular events in patients with vascular disease and preserved left ventricular systolic function. Results of the main randomized clinical trials that evaluated the benefit of ACE inhibitors in patients with vascular disease are discussed in this editorial. In particular, the different prognostic impact of ACE inhibitors in high-risk patients with and without heart failure or preserved left ventricular systolic function is examined in detail. The possible impact of lipids and statins on the effect of ACE inhibitors is also discussed. In our opinion, the available data indicate that ACE inhibitors should continue to be used in all patients with documented coronary artery disease or different phenotypes of high vascular risk, even in a context of modern and aggressive preventive strategies.

• Authors: Fabio Angeli, Gianpaolo Reboldi, Paolo Verdecchia
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 12 Issue 6 Pg. 839-43 (Apr 2011) ISSN: 1744-7666 [Electronic] England
• PMID: 21323501 (Publication Type: Editorial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors

Topics

• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Consensus
• Coronary Artery Disease (complications, diagnosis, drug therapy)
• Heart Failure (diagnosis, drug therapy, etiology)
• Humans
• Prognosis
• Randomized Controlled Trials as Topic
• Ventricular Dysfunction, Left (diagnosis, drug therapy, etiology)