The Safety of ACE Inhibitors for the Treatment of Hypertension and Congestive Heart Failure

Frank, Graham J.

doi:10.1159/000174560

Cited by 22 publications

(6 citation statements)

References 14 publications

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“…Older patients and those at high risk of first dose hypotension should be given a small test dose of a short acting drug and monitored closely for two hours. 22 23 Blood pressure, renal function, and serum potassium measurements should be repeated one week after starting treatment and one week after each increase in dose. Patients should then be monitored at least annually.…”

Section: Resultsmentioning

confidence: 99%

Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction

Mason

Young²,

Freemantle³

2000

BMJ

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Section: Resultsmentioning

confidence: 99%

Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction

Mason

Young²,

Freemantle³

2000

BMJ

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“…In 40% to 60% of patients with mild-to-moderate hypertension, ACEI monotherapy produces a satisfactory reduction in blood pressure; in this population, ACEIs contribute to reversal of cardiac hypertrophy. In patients with CHF, ACEIs relieve pulmonary congestion by a balanced reduction in cardiac preload and afterload, through various vascular mechanisms [103]. ACEIs have also been shown to improve endothelial dysfunction in patients with heart failure, as well as in patients with coronary artery disease and type 2 diabetes [98,104].…”

Section: Main Characteristics Of Raas-suppressing Drugsmentioning

confidence: 99%

Effects of ACE-Inhibitors and Angiotensin Receptor Blockers on Inflammation

Raimondo¹,

Tuttolomondo²,

Buttà³

et al. 2012

CPD

112

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Abstract:The role of inflammation in cardiovascular disease and in hypertensive disease above all, is complex. Several studies confirm that activation of renin-angiotensin-aldosteron system (RAAS), through increase in the production of angiotensin II (Ang II), is closely related to local vascular inflammation. Over the BP lowering effects of anti-hypertensive treatments, several ancillary effects for every class may be found, distinguishing the various drugs from one another. Given the pro-inflammatory effects of Ang II and aldosterone, agents that interfere with the components of RAAS, such as ACE inhibitors, Angiotensin Recpetor Blockers (ARBs), and mineralocorticoid receptor antagonists (spironolactone or the more selective eplerenone), represent logical therapeutic tools to reduce vascular inflammation and cardiovascular risk, as suggested in large clinical trials in patients with hypertension and diabetes. Regarding ACE inhibitors, actually there is no convincing evidence indicating that ACEi's reduce plasma levels of major inflammatory markers in hypertension models. Lack of evidence concerns especially these inflammation markers, such as fibrinogen of CRP, which are less closely related to atherosclerotic disease and vascular damage and conversely are affected by several more aspecific factors. Results obtained by trials accomplished using ARBs seem to be more univocal to confirm, although to great extent, these is an anti-inflmmatory effect of drugs bocking AT1 receptor. In order to strictly study the effects of blockage of RAAS on inflammation, future studies may explore different strategies by, for example, simultaneously acting on the ACE and the AT1 angiotensin receptors.

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“…Quinapril hydrochloride, a new nonsulfhydryl ACE inhibitor with a intermediate duration of action compared to captopril and enalapril, appears to have lower incidence of certain adverse effects than some other ACE inhibitors. [5][6][7] Quinapril has been extensively studied in patients with hypertension and CHF during a worldwide clinical development program. A comprehensive safety database was established to allow appropriate analysis across the large pool of patient safety data.…”

Section: Introductionmentioning

confidence: 99%

The safety profile of quinapril: Is there a difference among ACE inhibitors?

Canter¹,

Frank²,

Knapp³

et al. 2009

Clin Cardiol

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Summary: The safety of quinapril hydrochloride, a new nonsulfhydryl angiotensin-converting enzyme (ACE) inhibitor with an intermediate duration of action, has been evaluated in 3,031 patients with hypertension and congestive heart failure (CHF) and has been compared with other ACE inhibitors. A comparison of double-blind studies showed quinapril to have a lower incidence of adverse effects and withdrawals than reported for captopril or enalapril. Analysis of onset of adverse events or withdrawals did not show either a time-dependent or dosedependent relationship with quinapril. The proportion of patients who experienced orthostatic hypotension was less than that of patients on .captopril or enalapril. Doubleblind, long-term, and open-label studies with quinapril showed no increase in the incidence of events reported in patients with CHF compared with hypertensive patients. Quinapril produced minimal adverse effects on renal function in both patients with normal renal function and in those with pre-existing renal impairment. Age analysis of data from all studies showed no increase in total reporting of adverse events in older patients who did not take concomitant diuretics.

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The Safety of ACE Inhibitors for the Treatment of Hypertension and Congestive Heart Failure

Cited by 22 publications

References 14 publications

Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction

Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction

Effects of ACE-Inhibitors and Angiotensin Receptor Blockers on Inflammation

The safety profile of quinapril: Is there a difference among ACE inhibitors?

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