Publication

ROLE OF ANGIOTENSIN-CONVERTING ENZYME-INHIBITION IN ANGINA-PECTORIS

DEGRAEFF, PA. & VANGILST, WH., 1992, In : Journal of Cardiovascular Pharmacology. 19, p. S30-S37 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

There are various reasons to assume a beneficial effect of angiotensin-converting enzyme (ACE) inhibitors in patients with angina pectoris. Reduction of preload and afterload and a sympatholytic action may diminish myocardial oxygen demand. Local vasodilatory effects on the coronary vasculature may cause a relative increase in myocardial oxygen supply, although this can be nullified by the reduction in coronary perfusion pressure. Despite these potentially beneficial effects, placebo-controlled studies on exercise testing have shown variable results and do not justify the widespread use of these agents in chronic effort-induced angina pectoris. Nevertheless, certain subgroups of anginal patients may be identified in whom further studies are needed, especially patients who have unstable angina pectoris or are in the acute phase of myocardial infarction, patients with left ventricular dysfunction without overt heart failure, and patients with hypertension and left ventricular hypertrophy. Apart from this, ACE inhibitors may potentiate the effects of nitrates and reverse tolerance, especially inhibitors that contain a sulfhydryl group. In additional studies, a low starting dose and a long duration of treatment appear to be essential to optimize tissue penetration in the heart and to minimize negative effects due to the reduction in perfusion pressure.

Original languageEnglish
Pages (from-to)S30-S37
Number of pages8
JournalJournal of Cardiovascular Pharmacology
Volume19
Publication statusPublished - 1992
EventINTERNATIONAL SYMP ON THE CAPTOPRIL AND THROMBOLYSIS STUDY ( CATS ) : EARLY ACE INHIBITION IN MYOCARDIAL ISCHEMIA AND INFARCTION - , Netherlands
Duration: 8-Jun-1990 → …

Event

INTERNATIONAL SYMP ON THE CAPTOPRIL AND THROMBOLYSIS STUDY ( CATS ) : EARLY ACE INHIBITION IN MYOCARDIAL ISCHEMIA AND INFARCTION

08/06/1990 → …

Netherlands

Event: Other

    Keywords

  • ANGIOTENSIN-CONVERTING ENZYME INHIBITORS, ANGINA PECTORIS, NITRATES, CONGESTIVE HEART-FAILURE, CORONARY-ARTERY DISEASE, EXPERIMENTAL MYOCARDIAL ISCHEMIA, STABLE-EFFORT ANGINA, BLOOD-FLOW, SYSTEMIC HEMODYNAMICS, NORMOTENSIVE PATIENTS, NITRATE TOLERANCE, ESSENTIAL-HYPERTENSION, SULFHYDRYL-GROUP

ID: 6335753