Choosing a first-line drug in the management of elevated blood pressure: What is the evidence? 3: Angiotensin-converting-enzyme inhibitors
AUTOR(ES)
Wright, James M.
RESUMO
Elevated blood pressure is associated with an increased risk of cardiovascular illness and death. Efforts to reduce that risk have led to recommendations for a wide array of nondrug and drug therapies. Choosing the optimal first-line drug for hypertensive patients should address a hierarchy of treatment goals: decrease in morbidity and mortality associated with hypertension, decrease in blood pressure and other surrogate markers, good tolerance, dosing convenience and low cost. This article examines the evidence for angiotensin-converting-enzyme (ACE) inhibitors as a class of first-line antihypertensive drugs in light of these treatment goals. Overall, the evidence does not support the use of ACE inhibitors as first-line drugs in the management of most patients with hypertension, although they have proven benefit as second-line drugs for the treatment of congestive heart failure and left ventricular dysfunction secondary to myocardial infarction.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=80294Documentos Relacionados
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