TY - JOUR
T1 - Role and Optimal Dosing of Angiotensin-Converting Enzyme Inhibitors in Heart Failure
AU - Kazi, Dhruv
AU - Deswal, Anita
N1 - Funding Information:
This article is supported in part by grants from the VA Health Services Research and Development Service (IIR 02-082-1) and the VA Clinical Science Research and Development Service.
PY - 2008/2
Y1 - 2008/2
N2 - Based on overwhelming data demonstrating reduced morbidity and mortality, ACE inhibitors form a mainstay of therapy in all patients with symptomatic left ventricular systolic dysfunction. Furthermore, ACE inhibitors may be beneficial in the prevention of heart failure in patients with high-risk cardiovascular profiles. However, definite benefit from the use of ACE inhibitors in all patients with heart failure and preserved ejection fraction has not been demonstrated. Even though ACE inhibitors probably have a class effect in patients who have heart failure, it is recommended that ACE inhibitors that have been shown to reduce morbidity and mortality in clinical trials (captopril, enalapril, lisinopril, and ramipril) be used because studies have clearly defined a dose for these agents that is effective in modifying the natural history of the disease. Attempts should be made to up titrate patients to target doses of ACE inhibitors that have been used in clinical trials, if tolerated.
AB - Based on overwhelming data demonstrating reduced morbidity and mortality, ACE inhibitors form a mainstay of therapy in all patients with symptomatic left ventricular systolic dysfunction. Furthermore, ACE inhibitors may be beneficial in the prevention of heart failure in patients with high-risk cardiovascular profiles. However, definite benefit from the use of ACE inhibitors in all patients with heart failure and preserved ejection fraction has not been demonstrated. Even though ACE inhibitors probably have a class effect in patients who have heart failure, it is recommended that ACE inhibitors that have been shown to reduce morbidity and mortality in clinical trials (captopril, enalapril, lisinopril, and ramipril) be used because studies have clearly defined a dose for these agents that is effective in modifying the natural history of the disease. Attempts should be made to up titrate patients to target doses of ACE inhibitors that have been used in clinical trials, if tolerated.
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U2 - 10.1016/j.ccl.2007.12.001
DO - 10.1016/j.ccl.2007.12.001
M3 - Review article
C2 - 18312901
AN - SCOPUS:39749116807
SN - 0733-8651
VL - 26
SP - 1
EP - 14
JO - Cardiology Clinics
JF - Cardiology Clinics
IS - 1
ER -