Many heart disease patients who are already receiving state-of-the-art therapy do not benefit from additional treatment with angiotensin converting enzyme (ACE) inhibitors, according to results of a new study funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. The study provides the most definitive evidence to date of the effect of the drug in stable heart disease patients whose heart function was shown to be at normal or near-normal levels, and whose heart disease was already well managed. Researchers found that ACE inhibitors do not lower the risk of cardiovascular death, heart attack, or the need for coronary revascularization (bypass surgery or angioplasty to restore blood flow to clogged arteries) in these patients.
Results of the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) are being presented November 7 at the American Heart Association Scientific Sessions in New Orleans. They will also be published online concurrently by the New England Journal of Medicine and in the journal’s November 11 printed issue.* An editorial accompanies the article.
The American Heart Association currently recommends ACE inhibitors for all patients who have had a heart attack and others with coronary or other vascular disease. ACE inhibitors are a type of drug called vasodilators, meaning they cause blood vessel walls to widen or relax, thereby lowering blood pressure; they are one of several classes of drugs that are recommended for treating high blood pressure. Clinical studies have also found that ACE inhibitors improve survival and reduce the risk of heart attack among patients with heart failure, a condition in which the heart muscle is no longer pumping enough blood throughout the body. In addition, the drug has been shown to help prevent heart failure in some patients with moderate to severe ventricular dysfunction, or abnormalities in the lower chambers of the heart.
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