ACE Inhibitors in Heart Failure: Prospects and Limitations
dc.contributor.author | Pitt, Bertram | en_US |
dc.date.accessioned | 2006-09-11T14:58:12Z | |
dc.date.available | 2006-09-11T14:58:12Z | |
dc.date.issued | 1997-05 | en_US |
dc.identifier.citation | Pitt, Bertram; (1997). "ACE Inhibitors in Heart Failure: Prospects and Limitations." Cardiovascular Drugs and Therapy 11(1): 285-290. <http://hdl.handle.net/2027.42/44553> | en_US |
dc.identifier.issn | 0920-3206 | en_US |
dc.identifier.issn | 1573-7241 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/44553 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=9211022&dopt=citation | en_US |
dc.description.abstract | ACE inhibitors have been shown to be effective in reducing the morbidity and mortality of patients with left ventricular systolic dysfunction, but their application to clinical practice in this situation is still limited. In part, the failure to prescribe an ACE inhibitor to a patient with left ventricular systolic dysfunction is due to perceptions regarding their side effects, such as cough and renal dysfunction. Relatively few patients with left ventricular systolic dysfunction and a serum creatinine ≥2 mg/dl receive an ACE inhibitor in clinical practice. In this situation one should consider an agent such as fosinopril, which is metabolized by the liver as well as secreted by the kidney. In patients with moderate renal dysfunction, fosinopril has been well tolerated without an increase in serum creatinine. In patients who develope cough due to an ACE inhibitor, consideration should be given to an angiotensin II type 1 receptor blocking agent, such as losartan. The relative safety and efficacy of an ACE inhibitor compared with an angiotensin II type 1 receptor blocking agent is being explored in a prospective randomized trial (Evaluation of Losartan In The Elderly [ELITE]), as well as the safety and pharmacological effectiveness of adding an angiotensin II receptor antagonist to an ACE inhibitor (Randomized Angiotensin receptor antagonists–ACE-inhibitor Study [RAAS]). There may also be a role for the combination of an aldosterone receptor antagonists and an ACE inhibitor in patients with left ventricular systolic dysfunction. Once an ACE inhibitor is administered to a patient with left ventricular systolic dysfunction it should be continued indefinitely. ACE inhibitors may be of value not only in preventing the progression of heart failure but also in reversing endothelial dysfunction and preventing the development of atherosclerosis and its consequences, such as myocardial infarction. | en_US |
dc.format.extent | 124598 bytes | |
dc.format.extent | 3115 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Kluwer Academic Publishers; Springer Science+Business Media | en_US |
dc.subject.other | Medicine & Public Health | en_US |
dc.subject.other | Cardiology | en_US |
dc.subject.other | Heart Failure | en_US |
dc.subject.other | ACE Inhibitors | en_US |
dc.subject.other | Angiotensin II Type 1 Receptor Blocking Drugs | en_US |
dc.subject.other | Bradykinin | en_US |
dc.title | ACE Inhibitors in Heart Failure: Prospects and Limitations | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Biological Chemistry | en_US |
dc.subject.hlbsecondlevel | Chemistry | en_US |
dc.subject.hlbtoplevel | Science | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Cardiology, Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.identifier.pmid | 9211022 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/44553/1/10557_2004_Article_139131.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1023/A:1007795915009 | en_US |
dc.identifier.source | Cardiovascular Drugs and Therapy | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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