Inhibition of the renin-angiotensin system in the treatment of heart failure: why, when, and where.
Angiotensin converting enzyme inhibitors can be recommended in the treatment of severe cardiac failure (New York Heart Association Functional Class III or VI) where they are probably superior to other vasodilators. Their use should be considered when routine therapy with diuretics and digoxin has failed to ameliorate symptoms. Whether they can be recommended also for mild heart failure and whether the benefits outweigh any risks associated with long-term blockade of the renin-angiotensin system are questions that remain to be answered. Their use in hypertension and early in acute myocardial infarction might prevent the development of heart failure, but appropriate studies in man are awaited.
Nicholls
M G
MG
D000804:Angiotensin II / Q000037:antagonists & inhibitors; D000806:Angiotensin-Converting Enzyme Inhibitors; D000818:Animals; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004285:Dogs; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012306:Risk
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000804:Angiotensin II; D004077:Digoxin