title: Do ACE inhibitors all provide the same outcomes benefits in high-risk cardiovascular patients?
abstract: The Heart Outcomes Prevention (HOPE) trial was the first to demonstrate the benefits of the angiotensin-converting enzyme (ACE) inhibitor ramipril for high-risk cardiovascular patients. Whether the cardioprotective effects seen in HOPE and other trials are specific to distinct ACE inhibitors remains controversial. Evidence of a lack of class effect for ACE inhibitors has policy and financial implications related to reference pricing by insurers and inclusion on pharmacy formularies. Because head-to-head trials comparing the different ACE inhibitors are unforeseen, clinicians and administrators must rely on secondary-level data and observational studies. Only a handful of studies have sought to address the dispute over a class effect among ACE inhibitors, which is reviewed in this article.
authors.affiliation: Mount Sinai School of Medicine, Division of Cardiology, Box 1030, One Gustave Levy Place, New York, NY 10029, USA.
authors.forename: Anu
authors.initials: A
authors.lastname: Lala
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: McLaughlin
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000145:classification / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors