The evolving role of angiotensin-converting enzyme inhibition in heart failure: expanding the protective envelope.

Abstract

Congestive heart failure (CHF) continues to be a major cause of morbidity and mortality; in the United States alone, CHF afflicts 4 million patients, representing about 2% of the adult population; causes or contributes to more than 250,000 deaths yearly; and is the principal or secondary diagnosis in 6% of all hospital discharges. After the discovery of angiotensin-converting enzyme (ACE) inhibitors as potent antihypertensive agents, an increased understanding of the pathophysiology of CHF, in addition to the recognition of heart failure as a process that evolves through time, led to the use of these agents in patients with CHF. Subsequently, a series of multicenter trials systematically explored the role of ACE-inhibitor therapy in heart failure. The purpose of this review is to discuss some of these trials and to describe the answers that they provide to the following questions: Are vasodilators beneficial in the treatment of severe heart failure? Are ACE inhibitors beneficial in mild-to-moderate heart failure? Which vasodilator regimen (ACE inhibitors or hydralazine/isosorbide dinitrate) is more effective? Finally, are ACE inhibitors beneficial in asymptomatic patients at risk of heart failure?

• Authors: J R Teerlink
• Journal: Journal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 24 Suppl 3 Pg. S32-7 ( 1994) ISSN: 0160-2446 [Print] United States
• PMID: 7700062 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Review)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Vasodilator Agents

Topics

• Angiotensin-Converting Enzyme Inhibitors (administration & dosage, pharmacology, therapeutic use)
• Drug Therapy, Combination
• Female
• Heart Failure (drug therapy, mortality, prevention & control)
• Humans
• Longitudinal Studies
• Male
• Myocardial Infarction (pathology)
• Risk Factors
• United States
• Vasodilator Agents (administration & dosage, pharmacology, therapeutic use)