Blocking the renin-angiotensin-aldosterone system or lowering the blood pressure: does EUROPA help?
The EUropean trial on Reduction Of cardiac events with Perindopril in stable coronary Artery disease (EUROPA) demonstrated that the angiotensin- converting enzyme inhibitor, perindopril, compared with placebo, in patients with established coronary artery disease, reduced cardiovascular endpoints by 20% over a four-year follow-up period. Although the authors of this study claim that the risk reduction was best explained by blockade of the renin-angiotensin-aldosterone system, reference to recent meta-analyses of blood pressure (BP)-lowering trials provides compelling evidence that the benefits observed in the trial could be explained by the 5/2 mmHg BP difference between active and placebo treatments.
Mackay
Judy A
JA
Department of Medicine, Hillingdon Hospital, Uxbridge, UB8 3NN, UK. judyasever@aol.com
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D018849:Controlled Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy; D006331:Heart Diseases / Q000517:prevention & control; D006801:Humans; D020913:Perindopril / Q000627:therapeutic use*; D012084:Renin-Angiotensin System / Q000187:drug effects*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D020913:Perindopril