A Possible "Ace in the Hole" for Heart Disease Patients

A commonly prescribed drug that helps control high blood pressure in patients who have survived heart attacks or have congestive heart failure may be more advantageous than previously thought.

Angiotensin-converting enzymes, or ACE inhibitors, "have proven to be highly beneficial in the management of high blood pressure in congestive heart failure patients," said Dr. Jorge A. Garcia-Gregory, a Texas Heart Institute at St. Luke's Episcopal Hospital cardiologist. "They are my first choice in treating this problem."

Angiotensin is a protein in the blood, which, in its active form, causes blood vessels to constrict. This narrowing slows blood flow and raises blood pressure, which requires the heart to work harder than if the arteries were in their normal state. A certain enzyme within the body activates angiotensin and the resulting chemical reaction that causes this narrowing. The ACE inhibitor suppresses this enzyme so that the angiotensin stays inert.

"Recent studies also indicate the effectiveness of ACE inhibitors in the management of other heart conditions such as coronary artery disease," said Dr. Garcia. "Because lowering blood pressure has proven to increase survival rates for heart disease patients, ACE inhibitors are a logical therapy for many forms of cardiovascular disease."

However, Dr. Garcia also said ACE inhibitors are not for everyone.

"Though the most common side effect is a dry cough," said Dr. Garcia, "these medications are not easy for some people to tolerate."

Patients who take ACE inhibitors and experience problems should contact their physicians immediately. Do not stop taking the medication until instructed to do so, Dr. Garcia said, because the dosage needs to be adjusted gradually. Patients should check with their physicians to see if ACE inhibitors are right for them.

Brand names available in the United States include Accupril (quinapril), Altace (ramipril), Capoten (captopril), Lotensin (benazepril), Monopril (fosinopril), Prinivil (lisinopril), Univasc (moexipril), Vasotec (enalaprilat, enalapril), and Zestril (lisinopril).

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©2006 Texas Medical Center

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