PMID- 1290300
OWN - NLM
STAT- MEDLINE
DCOM- 19930325
LR  - 20061115
IS  - 0300-5860 (Print)
IS  - 0300-5860 (Linking)
VI  - 81 Suppl 4
DP  - 1992
TI  - [Prevention with angiotensin-converting enzyme (ACE) inhibitors].
PG  - 205-10
AB  - Preventive therapy by angiotensin-converting-enzyme (ACE) inhibitors is 
      considered in hypertension and, more recently, in chronic heart failure. The 
      mechanism of action of ACE-inhibitors is complex; most extensively studied, 
      however, is their inhibitory effect on angiotensin-II production. ACE-inhibitors 
      may act as vasodilators, reducing pre- and afterload. On the other hand, local 
      renin-angiotensin systems may control growth processes both in myocardial and in 
      smooth muscle cells. This may be another site of action for ACE-inhibitors. 
      ACE-inhibitors are reliable antihypertensive drugs and may have additional 
      specific effects on the heart and vascular smooth muscle. Clear evidence is, 
      however, missing for their superiority above other drugs in preventing 
      cardiovascular complications of hypertension. Most recently, the data of the 
      "study of left-ventricular dysfunction" (SOLVD) and "survival and ventricular 
      enlargement" (SAVE) study became available. These studies showed that 
      ACE-inhibitors could prevent the incidence of heart failure in about one-third of 
      patients with severe left-ventricular dysfunction during 3 years of observation 
      when compared with placebo treated patients. A new indication, therefore, for 
      ACE-inhibitors could be left ventricular dysfunction after myocardial infarction. 
      It remains unclear 1) what could be the adequate diagnostic procedures to 
      identify patients for preventive treatment, 2) when therapy should be started, 3) 
      about the duration of therapy, 4) about the doses of ACE-inhibitors for this 
      indication, 5) what will be the side-effects when used in a broader population, 
      and 6) will this prevention of heart failure be a specific effect of 
      ACE-inhibitors?
FAU - Ertl, G
AU  - Ertl G
AD  - Medizinische Klinik, Universitat Wurzburg.
FAU - Gaudron, P
AU  - Gaudron P
FAU - Neubauer, S
AU  - Neubauer S
FAU - Bauer, B
AU  - Bauer B
LA  - ger
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Pravention mit Angiotensin-Konversionsenzym(ACE)-Hemmern.
PL  - Germany
TA  - Z Kardiol
JT  - Zeitschrift fur Kardiologie
JID - 0360430
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
SB  - IM
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Animals
MH  - Coronary Circulation/*drug effects/physiology
MH  - Coronary Disease/*drug therapy/physiopathology
MH  - Humans
MH  - Hypertension/*drug therapy/physiopathology
MH  - Myocardial Ischemia/drug therapy/physiopathology
MH  - Ventricular Function, Left/drug effects/physiology
RF  - 37
EDAT- 1992/01/01 00:00
MHDA- 1992/01/01 00:01
CRDT- 1992/01/01 00:00
PHST- 1992/01/01 00:00 [pubmed]
PHST- 1992/01/01 00:01 [medline]
PHST- 1992/01/01 00:00 [entrez]
PST - ppublish
SO  - Z Kardiol. 1992;81 Suppl 4:205-10.