Document Detail


The current status of angiotensin converting enzyme inhibitors in the management of patients with chronic heart failure.
MedLine Citation:
PMID:  2681605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Angiotensin converting enzyme (ACE) inhibitors are the only therapeutic agents used in the treatment of chronic heart failure that have been shown to both improve symptoms and prolong life. These agents produce long-term haemodynamic and clinical benefits in about 60-65% of patients. The only reliable means of determining which patients are most likely to respond favourably to treatment is by a therapeutic trial; the response cannot be predicted by demographic factors, pretreatment left ventricular function or plasma renin activity. In addition to their symptomatic benefits, ACE inhibitors reduce the mortality of patients with chronic heart failure, possibly by decreasing ventricular wall stress and decreasing the frequency and complexity of ventricular arrhythmias. The most serious adverse effects of treatment, hypotension, functional renal insufficiency and potassium retention, occur most commonly in patients with the most advanced disease [New York Heart Association (NYHA) class III and IV heart failure] and when efforts are made to block the formation of angiotensin (Ang) II continuously (as with the use of long-acting ACE inhibitors). The unique characteristics of the ACE inhibitors support their use as first-line agents in patients with chronic heart failure.
Authors:
M Packer; M L Kukin; G W Neuberg; D J Pinsky; J Penn; M H Abittan
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Journal of hypertension. Supplement : official journal of the International Society of Hypertension     Volume:  7     ISSN:  0952-1178     ISO Abbreviation:  J Hypertens Suppl     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-12-19     Completed Date:  1989-12-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8501422     Medline TA:  J Hypertens Suppl     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  S33-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Mount Sinai School of Medicine, City University of New York, 10029.
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  therapeutic use*
Chronic Disease
Heart Failure / drug therapy*,  physiopathology
Hemodynamics / drug effects
Humans
Hypotension / chemically induced
Kidney / drug effects,  physiology
Potassium / metabolism
Risk Factors
Grant Support
ID/Acronym/Agency:
K04-HL-01229/HL/NHLBI NIH HHS; R01-HL-25055/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 7440-09-7/Potassium

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


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