Consider The Evidence: Med/Peds Journal Roundup

August 15, 2006

ACE-Is: ACE in the hole for atherosclerosis

Filed under: Cardiology, cardiovascular, lancet — medblog @ 11:12 pm

Lancet 8/12 – ACE inhibitors initially hit the big time due to two clearly beneficial effects: reduction of ventricular remodeling in heart failure, and renal protection in diabetes with hypertension. These studies also suggested ACE-inhibitors have some overall cardiovascular benefit independent of BP lowering and correction of heart failure. Could ACE inhibitors join statins as a class of drugs with multiple vascular benefits beyond the main mechnism it has traditionally known for??

Effects of ACE-Is were studied in the landmark trials HOPE, EUROPA and most recently PEACE. Dagenais et al.published an article looking at these three trials for statistical evidence of benefit in patients with atherosclerosis. And they found it: overall in the three trials, patients without heart failure on ACE therapy had significant risk reductions in cardivascular mortality, acute MI, and stroke. Each effect had an absolute risk reduction around 1%. Small, but significant.

Statins + ACE-inhibitors = crazy delicious.

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