Document Detail

Protective effects of angiotensin-converting enzyme inhibitors in high-risk African American men with coronary heart disease.
MedLine Citation:
PMID:  19878370     Owner:  NLM     Status:  MEDLINE    
Angiotensin-converting enzyme (ACE) inhibitors have been extensively used for the treatment of patients with cardiovascular disease, but several concerns have been raised about their efficacy in African American (AA) patients with heart failure, hypertension, and left ventricular hypertrophy. In this study the authors assessed the effect of ACE inhibitors on total and cardiovascular mortality in high-risk AA patients with angiographically proven coronary artery disease (CAD). This was a retrospective analysis of 810 AA men who underwent diagnostic coronary angiography between 1995 and 2003. All patients had demonstrable CAD and had undergone a complete ischemic workup. Follow-up was from 3 to 10 years. ACE inhibitors were administered to 237 patients, while the remaining 537 patients were not taking ACE inhibitors. Patients taking ACE inhibitors had significantly more comorbidities (hypertension, diabetes, left ventricular hypertrophy, heart failure, severe CAD) at baseline, compared with patients not taking ACE inhibitors (P<.05 for all comorbidities). Despite the unfavorable baseline profile, patients taking ACE inhibitors had significantly lower mortality from CAD during follow-up than patients who were not taking ACE inhibitors (P=.006). Stroke mortality rates were similar in both groups. Cox regression analysis showed an 80% higher relative risk in patients not receiving ACE inhibitors. These data indicate a substantial benefit from ACE inhibitor therapy in high-risk AA patients with CAD.
Vasilios Papademetriou; Christodoulos Kaoutzanis; Michael Dumas; Andreas Pittaras; Charles Faselis; Peter Kokkinos; Ross D Fletcher
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  11     ISSN:  1751-7176     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  621-6     Citation Subset:  IM    
Copyright Information:
2009 Wiley Periodical, Inc.
Medical Centers, Veterans Affairs and Georgetown University, Washington, DC, USA.
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MeSH Terms
African Americans / ethnology*
Angiotensin-Converting Enzyme Inhibitors / pharmacology,  therapeutic use*
Coronary Disease / drug therapy*,  ethnology*,  mortality
Follow-Up Studies
Heart Catheterization
Middle Aged
Regression Analysis
Renin-Angiotensin System / drug effects
Retrospective Studies
Risk Factors
Stroke / ethnology,  prevention & control
Survival Rate
Treatment Outcome
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors
Comment In:
J Clin Hypertens (Greenwich). 2009 Nov;11(11):648-50   [PMID:  19878375 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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