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ACE Inhibitors For Vascular Disease Patients

Researchers at the Laval University Heart and Lung Institute in Quebec have found that drugs used to treat heart failure also reduced the risk of death, heart attacks// and stroke in people with hardened arteries and hence should be considered in all vascular disease patients.

ACE inhibitors are drugs that lower blood pressure by inhibiting the formation of a chemical that causes arteries in the body to constrict. They are used to treat heart failure.

In an analysis of three major studies, they found that two out of the three studies involving nearly 30,000 people clearly showed such a benefit. The two studies that showed benefits looked at the incidence of heart attacks, stroke and overall deaths from heart disease, while the third study also looked at the incidence of procedures such as angioplasty in patients with atherosclerosis.

Kim Fox, a professor of clinical cardiology at Royal Brompton Hospital in London and a co-author of the report said that ACE inhibitors should be considered in all vascular disease patients.

Dr. Gilles R. Dagenais, a member of the research team said ACE inhibitors should be prescribed "for patients who have coronary heart disease and also atherosclerosis in major arteries, such as those in the brain, if there are no contraindications and if the physician judges there is benefit.”

However, two Italian Cardiologist have argued against the use of ACE inhibitors in such cases pointing to the results of the third study, which was not favorable.

Though the use of ACE inhibitors to reduce risk of vascular disease is debatable, Dr. Gary Francis, Head of the Cleveland Clinic Clinical cardiology section said that the Canadian interpretation was probably correct as it was done by a group highly qualified to do such studies.

Francis said, but "like all meta-analyses, it has some problems. It would be naive to believe that a meta-analysis would have power ov er a randomized, controlled study,"

He also said still "I have a low threshold to go to ACE inhibitors because there is a low price to pay for their benefits. They should be considered for all patients with atherosclerosis.”


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