[Angiotensin-converting enzyme inhibitors :from vasoactive drugs to cardiovascular prevention tools].
Abundant evidence showed that angiotensin-converting enzyme (ACE)-inhibitors reduce long-term cardiovascular morbidity and mortality rates in patients with heart failure and myocardial infarction. More recent studies revealed clinical benefits also in hypertensive patients with comorbidity and lead to an extension of clinical indications. Indeed in patients with severe hypertension differences between drugs are hardly detectable because the risk reduction is mainly related to the control of blood pressure values independent of the type of therapy. Conversely in the presence of comorbid conditions, especially in diabetics, the association of ACE-inhibitors with antihypertensive treatments proved its efficacy in reducing cardiovascular morbidity and mortality so that the role of mechanisms extending beyond blood pressure reduction can be postulated.
Modesti
Pietro Amedeo
PA
Clinica Medica Generale e Cardiologia Università degli Studi Viale Morgagni, 85 50134 Firenze. pa.modesti@dfc.unifi.it
Vanni
Simone
S
Gensini
Gian Franco
GF
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000627:therapeutic use; D006331:Heart Diseases / Q000188:drug therapy* / Q000401:mortality; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000401:mortality; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D002216:Captopril