The clinical role of angiotensin converting enzyme inhibitors in antihypertensive therapy in the 1990s.
The traditional stepped-care approach to antihypertensive therapy, which progresses from simple low-dose monotherapy with diuretics and/or beta-blockers to complex combined regimens, is credited with reduction of hypertension-related stroke morbidity and mortality. However, it has achieved little success in reducing hypertension-related coronary morbidity and mortality. Overall mortality of treated hypertensive patients has remained higher than that of the general population, despite decreases in the blood pressure. In the 1990s, hypertension will be viewed as one of several cardiovascular risk factors requiring individualized treatment that takes concomitant diseases into account. Angiotensin converting enzyme (ACE) inhibitors that do not adversely affect serum lipid and glucose levels will play a major role. This class of drugs will also receive attention because of its beneficial action on diabetic nephropathy and its promising cardioprotective effect achieved by improved coronary blood flow, prevention of left ventricular hypertrophy and prevention of certain potentially life-threatening arrhythmias.
Zanchetti
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Centro di Fisiologia Clinica e Ipertensione, Università di Milano, Milan, Italy.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects; D011788:Quality of Life; D013564:Sympathetic Nervous System / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors