[The role of converting enzyme inhibitor in the treatment of arterial hypertension].
Antihyertensive drugs are non of the preventive measures aimed at reducing cardiovascular mortality and morbidity. Seen from that angle, their blood pressure lowering effect is necessary but insufficient. Diuretics and beta-blockers prescribed as first-line treatment of moderate arterial hypertension have only partly fulfilled these requirements: they have significantly reduced the incidence of cerebral vascular accidents but have been unable to lower the incidence of coronary disease which is the main cause of death in hypertensive subjects. Because of this failure, the objectives of antihypertensive treatments had to be revised as follows. The first objective is to ensure a satisfactory control of blood pressure with good compliance, which means that the drugs must be well tolerated and easy to take regularly. The second objective os to reduce the rhythmic and metabolic factors of coronary disease. The third objective is to reverse left ventricular hypertrophy and vascular wall hypertrophy. CEI are as effective as diuretics or beta-blockers in controlling blood pressure, but they are better tolerated from the clinical, metabolic and rhythmic points of view and they act effectively on ventricular and vascular hypertrophy. Following this assessment, although CEI have not proved efficient as regards cardiovascular prevention, in 1988 the WHO authorities have decided that they should be used as first-line treatment in moderate arterial hypertension.
Denolle
T
T
Service d'hypertension artérielle, hôpital Broussais, Paris.
Azizi
M
M
Plouin
P F
PF
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D006332:Cardiomegaly / Q000517:prevention & control; D004342:Drug Hypersensitivity; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D012907:Smoking / Q000009:adverse effects; D014883:Water-Electrolyte Imbalance / Q000517:prevention & control
D000806:Angiotensin-Converting Enzyme Inhibitors; D008055:Lipids
Place des inhibiteurs de l'enzyme de conversion (IEC) dans le traitement de l'HTA.