Harvard Heart Letter

ACE inhibitors after bypass surgery

Their value immediately after surgery is being questioned.

Drugs known as angiotensin-converting enzyme (ACE) inhibitors can make all the difference in the world to length and quality of life for some people with heart disease and high blood pressure, one of the risk factors for heart disease. ACE inhibitors work by blocking hormones that regulate blood vessel constriction. This can reduce damage to the heart and kidneys in many ways—for example, by slowing deterioration of the heart muscle that occurs over time following a heart attack or deterioration of the kidneys in people with diabetes and kidney disease. The first ACE inhibitor, captopril (Capoten), was approved by the FDA in 1981 to lower blood pressure. Nine more are available today (see box).

In the early 1990s, the ability of ACE inhibitors to prolong survival in people with heart failure was discovered, along with their ability to lower the risk of having a heart attack. Soon thereafter, Harvard researchers led by Dr. Marc Pfeffer found that people taking ACE inhibitors were less likely to die from their heart attacks. These unique benefits secured the place of ACE inhibitors mong the most significant drugs for the treatment of heart disease.

ACE inhibitors

  • benazepril (Lotensin)

  • captopril (Capoten)

  • enalapril (Vasotec)

  • fosinopril (Monopril)

  • lisinopril (Prinivil, Zestril)

  • moexipril (Univasc)

  • perindopril (Aceon)

  • quinapril (Accupril)

  • ramipril (Altace)

  • trandolapril (Mavik)

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