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ACE Inhibitors

Click here for why I feel that Micardis® (telmisartan) should be the first line treatment for hypertension.

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• Hypertension / pulse pressure / hardening of the arteries / angiotensin II receptor blockers (ARBs) / ace inhibitors / alpha blockers / calcium channel blockers / diuretics / beta blockers / Renin Inhibitors /  Vanlev (omapatrilat) / aldosterone blockers / dihydropyridine (DHP) calcium antagonist / first line treatment for hypertension

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Alternative News:

• Long-term use of blood pressure drugs may cause kidney damage, study suggests - Science Daily, 1/12/22 - "the researchers found, long-term use of drugs that inhibit the renin-angiotensin system, such as ACE inhibitors, or angiotensin receptor blockers, have a similar effect. These drugs are widely used for many purposes, including treating high blood pressure, congestive heart failure and heart attacks, as well as to prevent major heart problems. But long-term use of the drugs was associated with hardened kidney vessels in both lab mice and humans, the scientists found"
• Common hypertension medications may reduce colorectal cancer risk - AHA, 7/6/20 - "those who took hypertension medications such as ACE-i or ARBs had a 22% lower risk of developing colorectal cancer in the subsequent three years"
• ACEI/ARBs Linked With Survival in Hypertensive, Chinese COVID-19 Patients - Medscape, 4/22/20 - "Among patients with hypertension hospitalized with COVID-19, inpatient treatment with ACEI [ACE inhibitor]/ARB [angiotensin receptor blocker] was associated with lower risk of all-cause mortality, compared with ACEI/ARB nonusers, during 28 days of follow-up. While study interpretation needs to consider the potential for residual confounders, it is unlikely that inpatient ACEI/ARB would be associated with an increased risk of mortality"
• ACE Inhibitors, ARBs Lower AF Risk in Hypertension - Medscape, 1/8/14 - "Compared with a beta-blocker and diuretic, the use of an ACE inhibitor reduced the incidence of atrial fibrillation 88% and 49%, respectively. There was no reduction in the incidence of atrial fibrillation when those treated with ACE inhibitors were compared with those who received calcium-channel antagonists. When the same analysis was repeated with ARBs, ARB use reduced the risk of atrial fibrillation 90% and 57%, respectively, when compared with beta-blockers and diuretics. Similarly, there was no reduction in risk when ARBs were compared with calcium-channel antagonists ... When the ARB-treated patients were compared with those who received an ACE inhibitor, the risk of atrial fibrillation was reduced 32%. None of the five medication classes tested differed with regard to the risk of stroke"
• Lower Diabetes Incidence in Patients Treated With ACEIs and ARBs - Medscape, 5/25/11 - "Over an average follow-up of 4.0 +/- 1.0 years, there were 1284 (8.5%) incident cases of diabetes in active-treated and 1411 (9.3%) cases in placebo-treated patients in the ACE inhibitor trials, and there were 2330 (12.4%) cases in active-treated and 2669 (14.2%) cases in placebo-treated patients in the ARB trials. Overall, active therapy reduced diabetes incidence compared with placebo (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.8-0.9; P < .01). ARBs significantly reduced diabetes incidence (OR, 0.8; CI, 0.8-0.9; P < .01). Incidence was also lower for ACEIs (OR, 0.8; CI, 0.7-1.0) but was only marginally significant (P = .07)"
• Nutrigenomics shows blood pressure benefits of cocoa - Nutra USA, 3/8/11 - "The magnitude of the hypotensive effects of cocoa is clinically noteworthy; it is in the range that is usually achieved with monotherapy of beta-blockers or antiotensin-converting enzyme inhibitors ... recruited 16 volunteers aged between 20 and 45, and asked them to eat 75 grams of dark chocolate with 72 percent cocoa content every day for two weeks" - [Abstract]
• Effects of cocoa extract and dark chocolate on angiotensin-converting enzyme and nitric oxide in human endothelial cells and healthy volunteers--a nutrigenomics perspective - J Cardiovasc Pharmacol. 2011 Jan;57(1):44-50 - "Evidence suggests that cocoa from the bean of Theobroma cacao L. has beneficial effects on cardiovascular disease. The aim of this study was to investigate if cocoa extract and dark chocolate influence angiotensin-converting enzyme (ACE) and nitric oxide (NO) in human endothelial cells (in vitro) and in healthy volunteers (in vivo) ... ACE activity and NO were measured at baseline and after 30, 60, and 180 minutes in 16 healthy volunteers after a single intake of 75 g of dark chocolate containing 72% cocoa. Significant inhibition of ACE activity (P < 0.01) and significant increase of NO (P < 0.001) were seen in HUVEC. In the study subjects, a significant inhibition of ACE activity (mean 18%) 3 hours after intake of dark chocolate was seen, but no significant change in NO was seen. According to ACE genotype, significant inhibition of ACE activity was seen after 3 hours in individuals with genotype insertion/insertion and deletion/deletion (mean 21% and 28%, respectively). Data suggest that intake of dark chocolate containing high amount of cocoa inhibits ACE activity in vitro and in vivo"
• Olive leaf extract may help hypertension: Frutarom study - Nutra USA, 3/9/11 - "Olive leaf extract, at the dosage regimen of 500 mg twice daily, was similarly effective in lowering systolic and diastolic blood pressures in subjects with stage-1 hypertension as Captopril, given at its effective dose of 12.5–25 mg twice daily ... after eight weeks of treatment, both treatment groups experienced significant reductions in systolic and diastolic blood pressure from baseline. They added that such reductions were not significantly different between groups ... However, they reported that a significant reduction of triglyceride level was observed for the group receiving olive leaf extract, but not in Captopril group ... the anti-hypertensive activity “lies probably in its content of oleuropein acting synergistically with other active substances to exert both ACE inhibitory and calcium channel blocking activities."" - [Abstract] - See olive leaf extract at Amazon.com.
• Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: Comparison with Captopril - Phytomedicine. 2011 Feb 15;18(4):251-8 - "Mean SBP at baseline was 149.3+/-5.58mmHg in Olive group and 148.4+/-5.56mmHg in Captopril group; and mean DBPs were 93.9+/-4.51 and 93.8+/-4.88mmHg, respectively. After 8 weeks of treatment, both groups experienced a significant reduction of SBP as well as DBP from baseline; while such reductions were not significantly different between groups. Means of SBP reduction from baseline to the end of study were -11.5+/-8.5 and -13.7+/-7.6mmHg in Olive and Captopril groups, respectively; and those of DBP were -4.8+/-5.5 and -6.4+/-5.2mmHg, respectively. A significant reduction of triglyceride level was observed in Olive group, but not in Captopril group. In conclusion, Olive (Olea europaea) leaf extract, at the dosage regimen of 500mg twice daily, was similarly effective in lowering systolic and diastolic blood pressures in subjects with stage-1 hypertension as Captopril, given at its effective dose of 12.5-25mg twice daily" - See olive leaf extract at Amazon.com.
• Why chocolate protects against heart disease - Science Daily, 11/10/10 - "ate 75 grams of unsweetened chocolate with a cocoa content of 72 percent. To analyze what happened with the ACE enzyme, blood samples were taken in advance and then a half hour, one hour, and three hours afterward ... In the sample taken three hours afterward, there was a significant inhibition of ACE activity. The average was 18 percent lower activity than before the dose of cocoa, fully comparable to the effect of drugs that inhibit ACE and are used as a first-choice treatment for high blood pressure"
• Pine bark extract may benefit blood pressure-related kidney health - Nutra USA, 3/5/10 - "55 hypertensive patients to participate in the randomized, controlled study. Subjects were assigned to receive Ramipril [an ACE inhibitor] (10 mg per day), and 29 of these people were randomly selected to also receive Pycnogenol (150 mg per day) ... After six months in the Ramipril-only group the albumin levels decreased by 26 per cent to 64 mg per 24-hour period, while additional Pycnogenol produced levels that averaged 39 mg per 24-hour period, equivalent to a 57 per cent decrease ... Statistically significant decreases in patients’ blood pressure were also observed, with systolic and diastolic blood pressures dropping by more than 30 and 8 per cent, respectively in the Ramipril-only group, and by a further 3 to 6 per cent in the combination group ... Diastolic and systolic blood flow improved by 8 and 12 per cent, in the combination group" - [Abstract] - See Pycnogenol at Amazon.com.
• Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants--a controlled study - J Cardiovasc Pharmacol Ther. 2010 Mar;15(1):41-6 - "evaluated the effects of Pycnogenol as an adjunct to angiotensin-converting enzyme (ACE)-inhibitor ramipril treatment of hypertensive patients presenting with early signs of renal function problems. One group of 26 patients was medicated with 10 mg ramipril per day only; a second group of 29 patients took Pycnogenol in addition to the ACE inhibitor over a period of 6 months ... Urinary albumin decreased from 87 +/- 23 to 64 +/- 16 mg/d with ramipril only. Additional Pycnogenol lowered albumin significantly better from 91 +/- 25 to 39 +/- 13 mg/day (P < .05). In both groups, serum creatinine was lowered; however, only in the combination treatment group did the effect reached statistical significance. In both groups, CRP levels decreased from 2.1 to 1.8 with ramipril and from 2.2 to 1.1 with the ramipril-Pycnogenol combination; the latter reached statistical significance. Kidney cortical flow velocity was investigated by Doppler color duplex ultrasonography. Both systolic and diastolic flow velocities increased significantly after 6 months medication with ramipril. The addition of Pycnogenol to the regimen statistically significantly further enhanced kidney cortical flow velocities, by 8% for diastolic flow and 12% for systolic flow, relative to values found for the group taking ramipril only" - See Pycnogenol at Amazon.com.
• New Findings On Green Tea - Life Extension Foundation - "Green tea is a natural ACE inhibitor."
• Conjugated Linoleic Acid Supplementation Enhances Antihypertensive Effect of Ramipril in Chinese Patients With Obesity-Related Hypertension - Am J Hypertens. 2009 Mar 19 - "Participants were randomized to a daily dose of 4.5 g/day CLA (nine 0.5-g capsules; a 50:50 isomer blend of c 9,t 11 and t 10,c 12 CLA) with 37.5 mg/day ramipril (group 1) or placebo with 37.5 mg/day ramipril (group 2) for 8 weeks ... Treatment with CLA significantly enhanced the reduction effect of ramipril on systolic BP and diastolic BP (P < 0.05). It also increased plasma adiponectin concentration (P < 0.05) and decreased plasma concentrations of leptin and angiotensinogen (P < 0.05); however, significant change was not observed in ACE activity" - See conjugated linoleic acid at Amazon.com.
• Chicken Soup May Help Fight High Blood Pressure - Science Daily, 10/13/08 - "Saiga and colleagues extracted collagen from chicken legs and tested its ability to act as an ACE inhibitor in the laboratory studies. They identified four different proteins in the collagen mixture with high ACE-inhibitory activity. Given to rats used to model human high blood pressure, the proteins produced a significant and prolonged decrease in blood pressure"
• Pine bark extract may boost diabetics' heart health - Nutra USA, 5/12/08 - "recruited diabetic subjects with an average age of 60 and randomly assigned them to receive daily supplements of Pycnogenol (125 mg) or placebo for 12 weeks ... All subjects were receiving pharmaceutical anti-hypertension treatment (angiotensin- converting enzyme [ACE] inhibitors) ... 58.3 per cent of subjects in the Pycnogenol group experienced blood pressure control, defined as attaining a stable systolic blood pressure, compared to 20.8 per cent in the placebo group ... use of ACE inhibitors was reduced by 50 per cent in the group receiving the pine bark extract ... a 23.7 mg/dL reduction in fasting blood glucose levels in the Pycnogenol group, compared to only 5.7 mg/dL in the placebo group" - See Pycnogenol at Amazon.com.
• Pine extract prevents heart failure damage in mice - Reuters, 5/22/07 - "The effectiveness of Pycnogenol supplementation is a great option for many people who want an alternative to prescription medications such as beta-blockers or ACE inhibitors" - See Pycnogenol products at Amazon.com.

Other News:

• Why Are We Still Prescribing Angiotensin-Converting Enzyme Inhibitors? - Medscape, 4/28/22 - "The reason that many continue prescribing ACE inhibitors in hypertension may well be that, years ago, our attending taught us that this drug class exerted unique cardioprotective properties. There is no question that this drug class has been shown to have more cardiovascular benefit than harm in placebo-controlled trials ... However, today's attending will teach us that efficacy and outcomes are similar for ACE inhibitors and ARBs, but adverse events are not. For practicing clinicians, this means that there is no longer any good reason to subject patients to the adverse effects of ACE inhibitors. ACE inhibitors may rapidly become a drug class of historical interest only"
• Blood Pressure Meds Tied to Increased Schizophrenia Risk - Medscape, 3/18/21 - "The major finding was that a one-standard deviation (1-SD) lower expression of the ACE gene in blood was associated with lower systolic blood pressure of 4.0 mm Hg (95% CI, 2.7 - 5.3), but also an increased risk of schizophrenia (odds ratio [OR], 1.75"
• Stopping RAS inhibitors tied to worse outcomes in patients with chronic kidney disease - Science Daily, 12/29/20 - "Renin-angiotensin system inhibitors (RAS inhibitors), including both ACE inhibitors (ending in 'pril') and ARBs (ending in 'sartan'), are common medications for the treatment of hypertension, cardiovascular disease, heart failure and CKD ... Small-scale studies have suggested that stopping RAS inhibitors in these patients may improve kidney function and delay the need for kidney replacement therapy ... Comparing morbidity and mortality rates in patients whose treatment was discontinued with those who continued the drug regimen, the researchers found that discontinuing these medications was associated with an eight percent lower risk of requiring kidney replacement therapy ... However, discontinuing was also linked to a thirteen percent higher risk of death at five years, and a twelve percent higher risk of suffering a heart attack or stroke"
• Blood pressure medication improves COVID-19 survival rates, research finds - Science Daily, 8/24/20 - "Covid-19 patients with high blood pressure who were taking ACEi/ARB medications were 0.67 times less likely to have a critical or fatal outcome than those not taking these medications"
• Comparative effects of ACE inhibitors and ARBs on response to a physical activity intervention in older adults: results from Lifestyle Interventions for Elders (LIFE) study - J Gerontol A Biol Sci Med Sci. 2019 May 9 - "Participants age 70-89 years were randomized to a physical activity (PA) or health education (HE) intervention. Outcomes included incident and persistent major mobility disability (MMD), injurious falls, Short Physical Performance Battery (SPPB), and gait speed ... Compared to ACEi users, ARB users had 28% lower risk (HR=0.72 [0.60-0.85]) of incident MMD and 35% (HR=0.65 [0.52-0.82]) lower risk of persistent MMD while no interaction between medication use and intervention was observed. Risk of injurious falls and changes in SPPB or gait speed were not different between ARB and ACEi users"
• Time to Ditch ACE Inhibitors for CVD? - Medscape, 4/5/18 - "There is "little, if any, clinical reason" to use angiotensin-converting enzyme (ACE) inhibitors for the treatment of hypertension or other cardiovascular indications because angiotensin receptor blockers (ARBs) are just as effective with fewer side effects"
• Risk of Breast Cancer With Long-term Use of Calcium Channel Blockers or Angiotensin-Converting Enzyme Inhibitors Among Older Women - Medscape, 4/26/17 - "Increasing duration of ACEi use was associated with reduced breast cancer risk: Compared with 1–<2 years of use, the adjusted hazard ratio was 0.76 (95% confidence interval: 0.63, 0.92) for 5–<6 years of use and 0.63 (95% confidence interval: 0.43, 0.93) for 9–<10 years of use. We conclude that among older women with hypertension, long-term CCB use does not increase breast cancer risk and long-term treatment with ACEis may confer protection against breast cancer"
• Blood pressure meds could raise your depression risk - CNN, 10/10/16 - "people taking one of two classes of drugs, known beta blockers or calcium channel antagonists, had twice the risk of being admitted into the hospital with a mood disorder, such as severe depression. However, people taking a class of drugs known as angiotensin blockers -- ACE inhibitors -- had a lower risk of developing severe mood disorders, even compared with healthy control groups with no history of hypertension or depression"
• New class of blood pressure meds as effective as old, analysis shows - Washington Post, 1/4/16 - "The new analysis, published in Mayo Clinic Proceedings on Monday, involves a second look at 106 randomized trials with 254,301 patients that took place after 2000 and shows that during this time period patient outcomes on the two medications were remarkably similar. The one difference they found was that ARBs tend to be better tolerated by patients, meaning that they have fewer side effects or result in fewer adverse events. ACE inhibitors are poorly tolerated by many patients because they can produce a bothersome dry cough, and some end up stopping medication as a result ... The other piece of good news regarding the medications is that ACE inhibitors, as well as many ARBs, are now generic -- meaning that the cost difference is minimal" - I've been pointing that out for years.  See my Telmisartan as a first line treatment page.
• Blood Pressure Meds May Cut Alzheimer’s Risk - WebMD, 9/14/15 - "People with early thinking and memory issues who took an ACE inhibitor or an ARB medication for their high blood pressure were less likely to get Alzheimer’s disease than those on other BP drugs ... A 2009 study also found that people taking ACE inhibitors that were crossing the brain barrier had a 65% lower risk of getting the disease compared to people taking other kinds of BP drugs"
• A meta-analysis of the effects of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers on insulin sensitivity in hypertensive patients without diabetes - Diabetes Res Clin Pract. 2014 Dec - "In patients showing no significant difference in blood pressure control, the comparison between ACEI and ARB showed that the former type of drug more effectively relieved IS in hypertensive patients without diabetes"
• Angiotensin-Converting Enzyme Inhibitor Therapy and Colorectal Cancer Risk - J Natl Cancer Inst. 2014 Jan 15 - "A nested case-control study was conducted using EPIC's General Practice Research Database (1987-2002) ... The adjusted odds ratios (ORs) of CRC were 0.84 (95% confidence interval [CI] = 0.72 to 0.98; P = .03) for or more years of ACE-I/ARB therapy and 0.75 (95% CI = 0.58 to 0.97; P = .03) for 5 or more years of exposure. The strength of this association increased with high-dose exposure (OR = 0.53; 95% CI = 0.35 to 0.79; P = .003 for ≥3 years of high-dose exposure). Among patients receiving antihypertensive medications, the association with long-term therapy was no longer statistically significant for ≥5 years), but the benefit of high-dose therapy remained (OR = 0.59; 95% CI = 0.39 to 0.89; P = .01 for ≥3 years of high-dose exposure)" - Note:  It might be one more reason to support telmisartan as a first line treatment for hypertension.
• ACE + ARB = Adverse Events - Medscape, 12/17/13 - "patients receiving the active drug combination had an excess occurrence of hyperkalemia and acute kidney injury. The hazard ratio for hyperkalemia was 2.8, and for acute kidney injury, it was 1.7. No benefit, excess risk, and the study was stopped early"
• Lowered Cancer Risk With ACE Inhibitors/ARBs: A Population-Based Cohort Study - J Clin Hypertens (Greenwich). 2013 Nov 8 - "Using the Taiwan National Health Insurance Research Database, 297,688 eligible study patients with essential hypertension were identified. According to their antihypertensive prescriptions, the study patients were stratified into an ACE inhibitor group, an ARB group, or a control group ... In the ACE inhibitor group compared with the control group, the hazard ratio was 0.51 (95% confidence interval, 0.39-0.68). In the ARB group compared with the control group, the hazard ratio was 0.8 (95% confidence interval, 0.65-0.97). Regular use of ACE inhibitors/ARBs was not associated with an increased risk of cancer development and was actually found to decrease overall cancer risk in this study"
• ACE Inhibitor and Angiotensin Receptor Blocker Use and Mortality in Patients with Chronic Kidney Disease - J Am Coll Cardiol. 2013 Nov 6 - "A logistic regression analysis was used to calculate the propensity of ACEI/ARB initiation in 141,413 US veterans with non-dialysis CKD previously unexposed to ACEI/ARB treatment ... inverse probability treatment weighing (IPTW) ... ACEI/ARB administration was associated with significantly lower risk of mortality both in the intention-to-treat analysis (HR=0.81; 95%CI: 0.78-0.84, p<0.001) and in the as-treated analysis with IPTW (OR=0.37; 95%CI: 0.34-0.41, p<0.001)"
• Clear association between ACE inhibitors, acute kidney injury - Science Daily, 11/6/13 - "ACE inhibitors and related drugs known as angiotensin receptor antagonists (ARAs or 'sartans') are the second most frequently prescribed medicines in UK clinical practice, and are used to treat common conditions such as high blood pressure, heart disease and kidney problems, especially in people with diabetes ... They compared the admission rates for acute kidney injury to English hospitals with the prescribing rates of ACE inhibitors and ARAs. From 2007/8 to 2010/11, there was a 52 per cent increase in acute kidney injury admissions. During this same period of time, there was an increase in the number of prescriptions for ACE inhibitors and ARAs issued by GP surgeries by 16 per cent ... The results show a clear association between the increase in prescriptions and the increase in hospital admissions" - Note:  It sounds like they call ARBs ARAs in England.  From what I've read, I don't think that kidney problem exists with telmisartan (an ARB).
• Angiotensin-Converting Enzyme Inhibitors and Alzheimer's Disease Progression in Older Adults: Results from the Réseau sur la Maladie d'Alzheimer Français Cohort - J Am Geriatr Soc. 2013 Sep 3 - "Memory clinics from 16 university hospitals in France ... Mini-Mental State Examination (MMSE) ... Continuous ACE-Is users had a 4-year decline in MMSE of 6.4 +/- 1.6 points (P < .001), intermittent ACE-Is users of 7.9 +/- 1.1 points (P < .001), continuous or intermittent users of other antihypertensive drugs of 8.8 +/- 0.7 points (P < .001), and never-users of 10.2 +/- 0.6 points (P < .001). MMSE decline between the four groups was significantly different (adjusted P = .02) ... The use of ACE-Is in older adults with AD is associated with a slower rate of cognitive decline independent of hypertension"
• Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study - Neurology. 2013 Aug 2 - "Secondary longitudinal data analysis of the Ginkgo Evaluation of Memory Study in older adults at least 75 years of age with normal cognition (n = 1,928) or MCI (n = 320) over a median 6.1-year period ... Hazard ratio for incident AD dementia among participants with normal cognition was 0.51 in diuretic (95% confidence interval [CI] 0.31-0.82), 0.31 in ARB (95% CI 0.14-0.68), 0.50 in ACE-I (95% CI 0.29-0.83), 0.62 in CCB (95% CI 0.35-1.09), and 0.58 in BB (95% CI 0.36-0.93) users and was not significantly altered when mean systolic blood pressure was above 140 mm Hg" - Note:  Sounds like the ARB's left the others in the dust.  See my telmisartan as a first line treatment page.
• Surprising new roles for a key regulatory enzyme of blood pressure - Science Daily, 9/8/12
• Blood pressure drugs linked with lower PTSD symptoms - Science Daily, 5/1/12 - "These data come from an observational study, not a randomized clinical trial, so it is important to limit our interpretation until larger, placebo-control, double-blinded trials can be performed ... Patients taking ACE inhibitors or ARBs had an approximately 30 percent decrease in PTSD symptom scores, but no significant differences were apparent for those taking other blood pressure medications, including beta-blockers, calcium channel blockers, and diuretics. In particular, individuals taking ACE inhibitors or ARBs tended to have lower levels of hyperarousal and intrusive thoughts" - See telmisartan or ramipril at OffshoreRx1.com.
• Angiotensin-II Receptor Antagonists: Their Place in Therapy - American Academy of Family Physicians, 6/00 - "The accumulation of bradykinin and substance P, as well as the activity of kininase II, is thought to increase bronchial reactivity and the potential for development of the dry, persistent cough associated with ACE inhibitors." - See substance P
• More Evidence That ARBs Have Cognitive Benefits - Medscape, 3/23/12 - "After stopping their antihypertensive medications, the patients were randomly assigned to the ARB candesartan (n = 20), the angiotensin-converting enzyme inhibitor (ACEI) lisinopril (n = 18), or the diuretic hydrochlorothiazide (n = 15) ... After adjustment for age and baseline score on the Mini-Mental State Examination, patients taking candesartan showed the greatest improvements on tests assessing executive function ... Our findings further support observational data showing that ARB use is associated with lower risk of dementia and Alzheimer disease compared with the use of ACEIs or other antihypertensives ... As reported previously by Medscape Medical News, Dr. Kehoe and colleagues recently published a study showing a 53% lower risk for Alzheimer's disease in older adults prescribed an ARB compared with those prescribed other antihypertensive agents"
• Heart medication best at bedtime, animal study suggests - Science Daily, 5/9/11 - "angiotensin-converting enzyme (ACE) inhibitors -- commonly given to patients with high blood pressure or after a heart attack or during heart failure -- improve heart structure and function when given at sleep time. In fact, when administered during wake time, ACE inhibitors are no more effective than a placebo, the study found ... The research was conducted on mice with high blood pressure ... The sleep-time benefit of giving the ACE inhibitor correlates with the biological rhythm of this hormone ... By targeting those hormones when they're highest during sleep, you're dropping their levels so they're not doing so much damage"
• Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers and Diabetes: A Meta-Analysis of Placebo-Controlled Clinical Trials - Am J Hypertens. 2011 Feb 17 - "new onset diabetes (NOD) ... Over an average follow-up of 4.0 +/- 1.0 years, there were 1,284/15,142 (8.5%) cases of NOD in active-treated and 1,411/15,130 (9.3%) cases in placebo-treated patients in the ACE inhibitor trials, and 2,330/18,756 (12.4%) cases in active-treated and 2,669/18,800 (14.2%) cases in placebo-treated patients in the ARB trials. Overall, active therapy reduced NOD compared to placebo (odds ratio (OR) 95%, confidence interval (CI): 0.8 (0.8-0.9); P < 0.01). Both ACE inhibitors (OR 95%, CI: 0.8 (0.7-1.0); P = 0.07) and ARBs (OR 95%, CI: 0.8 (0.8-0.9); P < 0.01) reduced NOD as compared to placebo. Active treatment reduced CV mortality (OR 95%, CI: 0.9 (0.8-1.0); P < 0.01) and had a favorable impact on non-CV mortality (OR 95%, CI: 0.7 (0.9-1.0); P = 0.2) as compared to placebo.ConclusionsOur findings demonstrated that ACE inhibitors or ARBs should be preferred in patients with clinical conditions that may increase risk of NOD, since these drugs reduced NOD incidence. In addition, these drugs have favorable effects on CV and non-CV mortality in high CV risk patients"
• Hypertension Drugs May Cut Alzheimer's Risk - WebMD, 1/12/10 - "The patients taking an angiotensin receptor blocker had a 19% lower risk of developing dementia compared to those taking lisinopril and a 24% lower risk compared to use of other blood pressure/heart medications. People taking both an ACE inhibitor and an angiotensin receptor blocker, which both target the angiotensin system, had a 46% lower risk of dementia compared with those taking other medications"
• ACEIs More Likely Than Other Antihypertensive Drugs to Cause Hyperkalemia - Medscape, 10/8/09
• Combination of vitamin K(2) and angiotensin-converting enzyme inhibitor ameliorates cumulative recurrence of hepatocellular carcinoma - J Hepatol. 2009 May 15 - "A 48-month follow-up revealed that the combination treatment with VK and ACE-I markedly inhibited the cumulative recurrence of HCC in association with suppression of the serum level of the vascular endothelial growth factor (VEGF); a central angiogenic factor. The serum level of lectin-reactive alpha-fetoprotein was also suppressed almost in parallel with VEGF. These beneficial effects were not observed with single treatment using VK or ACE-I" - See vitamin K at Amazon.com.
• Antihypertensive efficacy of telmisartan vs ramipril over the 24-h dosing period, including the critical early morning hours: a pooled analysis of the PRISMA I and II randomized trials - J Hum Hypertens. 2009 Feb 19 - "The adjusted mean treatment differences in the last 6-h mean ambulatory SBP/DBP were -5.8/-4.2 mm Hg after 8 weeks and -4.1/-3.0 mm Hg after 14 weeks, in favour of telmisartan (P<0.0001 for all four comparisons). Secondary end point results, including the mean 24-h ambulatory BP monitoring, day- and night-time BP and 24-h BP load, also significantly favoured telmisartan (P<0.0001). Both treatments were well tolerated; adverse events, including cough, were less common with telmisartan. These findings suggest that telmisartan is more effective than ramipril throughout the 24-h period and during the EMBPS; this may be attributable to telmisartan's long duration of effect, which is sustained throughout the 24-h dosing period" - Click here for why I feel telmisartan should be a first line treatment for hypertension. See telmisartan at OffshoreRx1.com.
• ACE Inhibitors May Protect Diabetics From Cancer, Peptic Ulcer - Medscape, 12/19/08 - "There was a significant association between ACE inhibitor use and the risk for cancer, with an adjusted odds ratio of 0.59 ... The rate of cancer among users of ACE inhibitors was 10% vs 15% for nonusers ... There was also a significant association between ACE inhibitor use and peptic ulcer disease, with an odds ratio of 0.68 ... The rate of peptic ulcer disease among ACE inhibitor users was 12% vs 16% among nonusers"
• Effects of Telmisartan and Ramipril on Adiponectin and Blood Pressure in Patients with Type 2 Diabetes - Am J Hypertens. 2008 Oct 30 - "There was a significant increase in adiponectin levels in the telmisartan (0.68 (95% confidence interval (CI), 0.27 to 1.10) microg/ml, P < 0.01) but not in the ramipril group" - See my adiponectin page.  An increase in adiponectin is a good thing.
• Telmisartan versus angiotension-converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials - J Hum Hypertens. 2008 Nov 6 - "Telmisartan had fewer drug-related adverse events than enalapril (RR 0.57, 95% CI 0.44-0.74), ramipril (RR 0.44, 95% CI 0.26-0.75), lisinopril (RR 0.70, 95% CI 0.56-0.89) and perindopril (RR 0.52, 95% CI 0.28-0.98). The meta-analysis indicates that telmisartan provides a superior BP control to ACEIs (enalapril, ramipril and perindopril) and has fewer drug-related adverse events and better tolerability in hypertensive patients" - Click here for reasons telmisartan might be a first line treatment.
• Beneficial Effects of Combination Therapy with Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor on Vascular Endothelial Function - Hypertens Res. 2008 Aug;31(8):1603-10 - "these results suggest that the angiotensin I-converting enzyme inhibitor perindopril is superior to the calcium channel blocker amlodipine for reducing vascular endothelial dysfunction when co-administered with angiotensin receptor blockers in patients with essential hypertension"
• Association of ACE Inhibitors and Angiotensin Receptor Blockers With Keratinocyte Cancer Prevention in the Randomized VATTC Trial - oncologystat.com, 9/3/08 - "squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) ... Time to new BCC was 2.5 years for ACE inhibitor or ARB users and 2.2 years for nonusers. The absolute incidence rate of BCCs per 1000 patient-years was lower among ACE inhibitor/ARB users than nonusers (154 vs 233; unadjusted incidence rate ratio [IRR] = 0.66 ... Time to new SCC was 2.9 years for ACE inhibitor or ARB users and 2.6 years for nonusers. The absolute incidence rate of BCCs per 1000 patient-years was lower among ACE inhibitor/ARB users than nonusers (83 vs 141; unadjusted IRR = 0.58"
• Angiotensin Inhibitors And Receptor Blockers Linked To Lower Risk Of Nonmelanoma Skin Cancer - Science Daily, 8/28/08 - "The group taking either an ACE inhibitor or ARBs had a 39 percent relative reduction in incidence of basal cell cancer and a 33 percent relative reduction in squamous cell cancers compared with nonusers"
• Effects of Angiotensin Converting Enzyme Inhibitor and Angiotensin II Receptor Antagonist Combination on Nitric Oxide Bioavailability and Atherosclerotic Change in Watanabe Heritable Hyperlipidemic Rabbits - Hypertens Res. 2008 Mar;31(3):575-84 - "1) vehicle (control), 2) the ACEI enalapril (E: 3 mg/kg/day), 3) the ARB losartan (L: 30 mg/kg/day) and 4) enalapril (1.5 mg/kg/day) + losartan (15 mg/kg/day) (E+L). Intra-aortic infusion of ACh produced an increase in plasma NO concentration, which was significantly greater with all the drug treatments than with the control. E increased ACh-induced NO significantly more than L (by 6.9 nmol/L, and 4.7 nmol/L, respectively). E+L increased ACh-induced NO by 9.5 nmol/L, significantly more than either E or L ... the combined treatment with an ACEI and an ARB may have additive protective effects on endothelial function as well as atherosclerotic change"
• Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, or Both for Patients With Proteinuria? A Best Evidence Review - Medscape, 5/20/08 - "Most significantly, the addition of ACEIs to ARBs reduced proteinuria to a greater degree than ARBs alone (ratio of means 0.76 at 1 to 4 months and 0.75 at 5 to 12 months). Combination therapy was also superior to treatment with ACEIs alone ... The 2 important conclusions that can be drawn from this meta-analysis are that ARBs are not superior to ACEIs in improving proteinuria, and that the combination of these 2 treatments appears superior in this outcome compared with either treatment alone ... Two of the biggest safety concerns regarding the combination therapy include the risks for hyperkalemia and acute worsening of renal function. A review of the literature, however, suggests that these risks may not be significantly worse with combination treatment vs monotherapy"
• ACE Inhibitors May Help in Weight Loss - WebMD, 4/28/08 - "the ACE-deficient mice not only broke down fats faster in the liver, they processed blood sugars more quickly than the other mice, making them less likely to develop diabetes ... The study results demonstrate that an ACE deficiency leads to reduction in body fat accumulation in mice and suggests that drugs that affect the renin-angiotensin system, such as ACE inhibitors, might spark weight loss, especially in the midsection" - See ramipril (an ACE inhibitor) at OffshoreRX.
• Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events - N Engl J Med. 2008 Mar 31 - "Telmisartan was equivalent to ramipril in patients with vascular disease or high-risk diabetes and was associated with less angioedema. The combination of the two drugs was associated with more adverse events without an increase in benefit" - Yeah but if you have to go with two drugs it sure seems like it's the least of all the evils regarding side effects.  See telmisartan at OffshoreRx1.com.
• ONTARGET: ARB Similar to ACE - Medscape, 3/31/08 - "The angiotensin receptor blocker (ARB) telmisartan (Micardis, Boehringer Ingelheim) was "noninferior" to the ACE inhibitor ramipril in patients with vascular disease or high-risk diabetes in the landmark ONTARGET trial"
• 2-drug Blood Pressure Therapy Dramatically Lowers Cardiovascular Risk - Science Daily, 3/31/08 - "One group received a tablet containing benazepril, which is a type of drug called an ACE inhibitor, and amlodipine, which belongs to a class of drugs known as calcium channel blockers or CCBs. The other pill combined benazepril and hydrochloro-thiazide, a type of diuretic or "water pill." The 20 percent reduction in cardiovascular events was observed with the ACE/CCB combination tablet"
• Effects of Ramipril on Endothelial Function and the Expression of Proinflammatory Cytokines and Adhesion Molecules in Young Normotensive Subjects With Successfully Repaired Coarctation of Aorta A Randomized Cross-Over Study - J Am Coll Cardiol. 2008 Feb 19;51(7):742-749 - "Ramipril reversed the impaired endothelial function and decreased the expression of proinflammatory cytokine IL-6, sCD40L, and adhesion molecules in normotensive subjects with SCR. These findings imply that ramipril treatment may have antiatherogenic effects in subjects with SCR, even in the absence of arterial hypertension" - Note:  Ramipril was my first line choice for combo therapy.
• Establishing A New Option for Target-organ Protection: Rationale for ARB Plus ACE Inhibitor Combination Therapy - Am J Hypertens. 2008 Jan 24 - "Combination therapy targeting RAS activation may reduce target-organ damage and provide superior blood pressure (BP) control; combining angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) represents one possible approach"
• ACE Inhibitors or ARBs in Hypertension? In Chronic Kidney Disease? - Medscape, 1/17/07 - "ARBs and ACE inhibitors were similarly effective at lowering proteinuria, ARBs were more effective than calcium-channel blockers, and a combination of ARBs and ACE inhibitors was more effective than either agent alone"
• ACE Inhibitors vs ARBs in HTN and in CKD - Medscape, 1/4/08 - "In the setting of chronic kidney disease (CKD), concludes the other study, which is a meta-analysis, ACE inhibitor and ARB monotherapy are similarly effective at reducing proteinuria, but a combination of the two angiotensin-2-suppressing drugs works better than either agent individually [2]. But a blanket recommendation to combine them would be premature, according to the authors, because there is little evidence that the combination would improve clinical outcomes over monotherapy, and the safety of such combination therapy is largely undefined"
• Blood Pressure Drug Telmisartan Shows Powerful Activity Against Stroke, Study Suggests - Science Daily, 12/17/07 - "83 percent of rats given no medication showed signs of stroke, as did 56 percent of rats given ramipril alone. However, no strokes were noted in the telmisartan-only or the telmisartan/ramipril combo groups ... Telmisartan's ability to easily pass through the blood-brain barrier (something ramipril cannot do) is likely behind the neuroprotective effect noted in the study"
• Renoprotective effect of the addition of losartan to ongoing treatment with an Angiotensin converting enzyme inhibitor in type-2 diabetic patients with nephropathy - Hypertens Res. 2007 Oct;30(10):929-35 - "During the 12-month treatment, addition of losartan or addition of an ACE-I to the treatment protocol reduced systolic blood pressure (SBP) by 10% and 12%, diastolic blood pressure (DBP) by 7% and 4%, and urinary albumin excretion by 38% and 20% of the baseline value, respectively. However, the effects on both BP and urinary albumin were not significantly different between the two therapies. In conclusion, addition of losartan or an ACE-I to an ongoing treatment with an ACE-I, or addition of an ACE-I to ongoing treatment with a conventional antihypertensive were equally effective at reducing the urinary albumin excretion and BP, and provided renal protection in patients with type-2 diabetic nephropathy"
• Prevention of Type 2 diabetes: fact or fiction? - Expert Opin Pharmacother. 2007 Dec;8(18):3147-58 - "the DREAM (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication) study (n = 5269) demonstrated that rosiglitazone at 8 mg once/day in subjects with prediabetes (IGT and/or impaired fasting glucose) was effective in reducing the risk of diabetes by 60%"
• Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension - Ann Intern Med. 2007 Nov 5 - "Available evidence shows that ACE inhibitors and ARBs have similar effects on blood pressure control, and that ACE inhibitors have higher rates of cough than ARBs. Data regarding other outcomes are limited"
• Common Medications Provide Equal Blood Pressure Control - Doctor's Guide, 11/2/07 - "Two common classes of blood pressure medications – angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) �� are equally effective at controlling high blood pressure ... ACEIs are slightly more likely than ARBs to cause a harmless but persistent dry cough ... If left untreated, high blood pressure can cause catastrophic health problems: the heart may enlarge, which can lead to heart failure; small bulges --aneurysms -- may form in blood vessels, including the aorta (the main artery to the heart) and others in the brain, legs, and intestines; blood vessels in the kidney may narrow, causing kidney failure; blood vessels in the eyes may burst or bleed, possibly leading to blindness; and arteries throughout the body may "harden" faster, potentially leading to heart attack or stroke"
• Do ACE inhibitors and ARBs mix well? Analysis urges caution - theheart.org, 10/10/07 - "patients receiving both an ACE inhibitor and an ARB were more likely not to comply with therapy due to side effects, which included hypotension, cough, angioedema, worsening renal function as defined by a change in serum creatinine >0.5 mg/dL, hyperkalemia as defined by serum potassium level changes >5.5 mEq/L, and symptomatic hypotension"
• Adverse Effects of Combination Angiotensin II Receptor Blockers Plus Angiotensin-Converting Enzyme Inhibitors for Left Ventricular Dysfunction: A Quantitative Review of Data From Randomized Clinical Trials - Arch Intern Med. 2007 Oct 8;167(18):1930-6 - "there were significant increases in worsening renal function (RR, 2.17 [95% CI, 1.59-2.97] and RR, 1.61 [95% CI, 1.31-1.98], respectively), hyperkalemia (RR, 4.87 [95% CI, 2.39-9.94] and RR, 1.33 [95% CI, 0.90-1.98], respectively"
• Heart drug 'boosts' OAP fitness - BBC News, 10/10/07 - "Researchers discovered older people became more active when they were given an ACE inhibitor called perindopril ... After 20 weeks, the research team discovered those who had been taking the active drugs were able to take more exercise and had a better quality of life than the placebo group"
• Rationale for double renin-angiotensin-aldosterone system blockade - Am J Cardiol. 2007 Aug 6;100(3A):25J-31J - "The clinical benefits of both angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) extend beyond blood pressure reduction to encompass tissue-protective effects in target organs, such as the heart, vasculature, and kidneys, that underlie the reductions in cardiovascular mortality and morbidity seen in large outcome trials. However, these effects are achieved by different mechanisms. ACE inhibitors reduce circulating and tissue angiotensin II levels and potentiate the beneficial effects of bradykinin, including generation of nitric oxide (NO). By contrast, the protective effects of ARBs are owing to the blockade of the angiotensin II type 1 (AT(1)) receptors and possibly also to the stimulation of angiotensin II type 2 (AT(2)) receptors, again resulting in NO release. In addition, some ARBs, such as telmisartan, are selective activators of peroxisome proliferator-activated receptor-gamma (PPAR-gamma), thereby increasing insulin sensitivity. In contrast to other PPAR-gamma ligands, such as the thiazolidinediones, activation of this receptor by telmisartan does not result in weight gain. The complementary mechanisms of action of ACE inhibitors and ARBs create a rationale for combination therapy in high-risk patients"
• Angiotensin receptor blockers versus angiotensin-converting enzyme inhibitors: where do we stand now? - Am J Cardiol. 2007 Aug 6;100(3A):38J-44J - "Both classes of agent can prevent or reverse endothelial dysfunction and atherosclerosis, thereby potentially reducing the risk of cardiovascular events. Such a reduction has been shown with ACE inhibitors in patients with coronary artery disease, but no such data are currently available for ARBs. Both ACE inhibitors and ARBs have been shown to reduce damage in target organs, such as the heart and kidney, and to decrease cardiovascular mortality and morbidity in patients with congestive heart failure"
• New opportunities in cardiovascular patient management: a survey of clinical data on the combination of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers - Am J Cardiol. 2007 Aug 6;100(3A):45J-52J - "Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) differ in their actions on the renin-angiotensin-aldosterone system (RAAS). ACE inhibitors prevent the formation of angiotensin II, although angiotensin II may still be generated by alternative pathways. However, ACE inhibitors interrupt bradykinin breakdown, which in turn potentially enhances nitric oxide and prostacyclin mechanisms. In contrast, ARBs selectively prevent the binding of angiotensin II to the angiotensin type 1 (AT(1)) receptor while leaving the potentially beneficial effects of the AT(2) receptor unaffected. The supposition is that dual blockade of the RAAS effectively overcomes the harmful effects of angiotensin II mediated by the AT(1) receptor while offering the additional effects of the ACE inhibitor"
• ACE-I/ARB treatment in type 1 diabetes patients with albuminuria is associated with lower odds of progression of coronary artery calcification - J Diabetes Complications. 2007 Sep-Oct;21(5):273-9 - "coronary artery calcification (CAC) ... In backward logistic regression, presence of albuminuria at baseline predicted progression of CAC among subjects not treated with ACE-I/ARB [odds ratio=4.06 ... Among the subjects with albuminuria, the odds of progression was 62% lower (95% CI=88% decrease to 23% increase; P=.106) in those treated with ACE-I/ARB ... Albuminuria is a significant independent risk factor for CAC progression in young type 1 diabetes patients asymptomatic for CAD, and ACE-I/ARB treatment is associated with substantially lower odds of CAC progression"
• ACE Inhibitors May Protect Against Mental Decline - Clinical Psychiatry News, 8/07 - "The group of patients on an antihypertensive other than an ACE inhibitor had a mean decline in exam scores of 0.64 points per year. Those on an ACE inhibitor had a mean decline of 0.38 points per year ... It is thought that some ACE inhibitors protect from dementia and mental decline by decreasing oxidative stress and inflammation in the brain"
• Telmisartan May Help Preserve Renal Function in Patients With Hypertension, Diabetes - Medscape, 6/1/07 - "In patients with hypertension and type 2 diabetes, telmisartan and ramipril both may help preserve cardiovascular and renal function by increasing nitric oxide (NO) activity of the renal endothelium"
• Treating the metabolic syndrome - Expert Rev Cardiovasc Ther. 2007 May;5(3):491-506 - "appropriate treatment of MS components often requires pharmacologic intervention with insulin-sensitizing agents, such as metformin and thiazolidinediones, while statins and fibrates, or angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are the first-line lipid-modifying or antihypertensive drugs"
• Combination therapy with an ACE inhibitor and an angiotensin receptor blocker for diabetic nephropathy: a meta-analysis - Diabet Med. 2007 May;24(5):486-93 - "This meta-analysis suggests that ACEI + ARB reduces 24-h proteinuria to a greater extent than ACEI alone. This benefit is associated with small effects on GFR, serum creatinine, potassium and blood pressure"
• The effect of telmisartan and ramipril on early morning blood pressure surge: a pooled analysis of two randomized clinical trials - Blood Press Monit. 2007 Jun;12(3):141-147 - "Telmisartan significantly reduced the early morning systolic blood pressure surge compared with ramipril"
• Combination ACE inhibitor and angiotensin receptor blocker therapy - future considerations - J Clin Hypertens (Greenwich). 2007 Jan;9(1):78-86. - "The individual gains seen with each of these drug classes have led to speculation that their combination might offer additive if not synergistic outcome benefits. The foundation of this hypothesis, although biologically possible, has thus far not been sufficiently well proven to support the everyday use of these 2 drug classes in combination. Additional outcomes trials, which are currently proceeding to their conclusion, may provide the necessary proof to support an expanded use of these 2 drug classes in combination"
• Early Treatment With ACE Inhibitors Urged To Reduce Long-Term Dialysis Risk - Science Daily, 5/21/07 - "For young patients with the kidney disease IgA nephropathy (IgAN), early treatment with angiotensin-converting enzyme (ACE) inhibitors can reduce the long-term risk of irreversible kidney damage"
• Some Hypertension Drugs May Help Reduce Dementia Risk - Doctor's Guide, 5/7/07
• Some Hypertension Drugs May Help Reduce Dementia Risk - Science Daily, 5/5/07 - "Centrally acting drugs include captropril (Capoten®), fosinopril (Monopril®), lisinopril (Prinivil® or Zestri®), perindopril (Aceon®), ramipril (Altace®) and trandolapril (Mavik®) ... The study found a link between taking centrally active ACE inhibitors and lower rates of mental decline as measured by the Modified Mini-Mental State Exam, a test that evaluates memory, language, abstract reasoning and other cognitive functions"
• Effect of antihypertensive agents on plasma adiponectin levels in hypertensive patients with metabolic syndrome - Nephrology (Carlton). 2007 Apr;12(2):147-53 - "Ramipril and valsartan increased the plasma adiponectin levels significantly higher than the other regimens"
• ACE Inhibitors Provide Greater Heart Protection - Science Daily, 4/22/07 - "Our research evaluated the effects of both drugs, and found that they both provided comparable blood pressure reduction. However, ACE inhibitors reduced the risk of coronary heart disease in patients by a further 9%. This so-called blood pressure-independent effect was not seen for ARBs"
• Superior effect of an angiotensin-converting enzyme inhibitor over a diuretic for reducing aortic systolic pressure - J Hypertens. 2007 May;25(5):1095-1099 - "a diuretic, like a beta-blocker agent, is not as effective a therapy as an ACE inhibitor in reducing aortic systolic and pulse pressure, and that the difference is not attributable to a change in heart rate"
• Treating hypertension in the patient with overt diabetic nephropathy - Semin Nephrol. 2007 Mar;27(2):182-94 - "The renoprotective and proteinuria-decreasing effects of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers recommend these agents as the standard of care in type 2 diabetic nephropathy"
• The effects of quinapril and atorvastatin on the responsiveness to sildenafil in men with erectile dysfunction - Vasc Med. 2006 Nov;11(4):251-7 - "International Index of Erectile Function (IIEF) questionnaire ... Compared to placebo, quinapril (p < 0.01) significantly improved symptoms of ED as measured by the IIEF-5 questionnaire. There was a trend toward a significant improvement in IIEF-5 with atorvastatin"
• Effect of inhibition of the Renin-Angiotensin system on development of type 2 diabetes mellitus (meta-analysis of randomized trials) - Am J Cardiol. 2007 Apr 1;99(7):1006-12. Epub 2007 Feb 16 - "In ACE inhibitor trials, the odds of developing DM were reduced by 28% (OR 0.72, 95% CI 0.63 to 0.84, p <0.001), and in the 5 ARB studies, there was a 27% reduction (OR 0.73, 95% CI 0.64 to 0.84, p <0.001) in the odds. In conclusion, evidence accumulated to date indicates that inhibition of the renin-angiotensin system may contribute to the prevention of DM"
• Blood Pressure Drug Shrinks Lung Cancer Tumors In Mice - Science Daily, 3/15/07 - "The study may explain the molecular mechanism for a decreased risk of lung cancers in patients with high blood pressure taking ACE inhibitors"
• Impact of Telmisartan Versus Ramipril on Renal Endothelial Function in Patients with Hypertension and Type 2 Diabetes - Diabetes Care. 2007 Mar 2 - "In patients with type 2 diabetes telmisartan and ramipril both increased NO activity of the renal endothelium significantly that in turn may support the preservation of cardiovascular and renal function"
• Rosiglitazone, Not Ramipril, Prevents Progression to Diabetes in Patients - Medscape, 12/14/06 - "After a median 3 years of follow-up, the primary outcome of diabetes or death occurred significantly less often in patients who received rosiglitazone than in those who received placebo (12% vs. 26%); the difference was due entirely to a reduction in incident diabetes ... Ramipril recipients were significantly more likely than placebo recipients to regress to normoglycemia (42% vs. 38%), but a trend toward a lower rate of incident diabetes in patients who received ramipril did not reach statistical significance"
• Blood Pressure Drugs Could Help Halt Pancreatic Cancer Spread, Researchers Find - Science Daily, 12/8/06 - "two types of pressure-lowering drugs -- ACE inhibitors and AT1R blockers -- may help reduce the development of tumor-feeding blood vessels, a process called angiogenesis. Such drugs, they say, may become part of a novel strategy to control the growth and spread of cancer ... In the test tube, Ang II significantly enhanced VEGF production in AT1R-positive cells. Captopril and losartan both blocked this effect"
• Fasting Glucose Increases in Older Adults With Hypertension Regardless of Treatment Type - Medscape, 11/16/06 - "randomized to receive treatment with chlorthalidone, amlodipine, or lisinopril to reduce blood pressure to less than 140/90 mm Hg ... During the first 2 years, the mean increase is serum glucose levels was 8.5, 5.5, and 3.5 mg/dL among the chlorthalidone, amlodipine, and lisinopril groups, respectively"
• Fasting glucose levels and incident diabetes mellitus in older nondiabetic adults randomized to receive 3 different classes of antihypertensive treatment: a report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) - Arch Intern Med. 2006 Nov 13;166(20):2191-201 - "Mean FG levels increased during follow-up in all treatment groups. At year 2, those randomized to the chlorthalidone group had the greatest increase (+8.5 mg/dL [0.47 mmol/L] vs +5.5 mg/dL [0.31 mmol/L] for amlodipine and +3.5 mg/dL [0.19 mmol/L] for lisinopril)" - Note:  Chlorthalidone is a beta blocker, amlodipine is a calcium channel blocker and lisinopril is an ACE inhibitor.  I don't believe that is true for all ACE inhibitors though.  See:
  • Blood Pressure Drugs May Help People Avoid 'Type 2' Disease, but Healthy Habits Still Best - WebMD, 10/16/01 - "people at high risk for developing diabetes who take the drug Altace [ramipril] were 34% less likely to develop diabetes than those who did not get the drug"
• ACE Inhibitors Reduce Kidney Disease Risk in Diabetics with High Blood Pressure - Doctor's Guide, 11/2/06 - "Taking an ACE inhibitor, alone or as part of the combination treatment, provided further protection against diabetic kidney disease"
• Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Type 1 Receptor Blockers on the Rate of New-Onset Diabetes Mellitus: A Review and Pooled Analysis - Pharmacotherapy. 2006 Sep;26(9):1297-306 - "The combined occurrence of new-onset diabetes in all 13 studies was 2249 cases among 31,283 patients (7.2%) in the ACE inhibitor or ARB group versus 3230 cases among 35,988 patients (9.0%) in the control group"
• ACE Inhibitors Help All Heart Patients - Doctor's Guide, 9/10/06 - "the addition of an ACE inhibitor reduced the risk of death from any cause -- heart failure, heart attack, or stroke -- even among very low-risk patients and those taking other heart-protecting drugs like low-dose aspirin, cholesterol-lowering statins, and beta- blockers"
• ACE Inhibitors and Angiotensin Receptor Antagonists and the Incidence of New-Onset Diabetes Mellitus : An Emerging Theme - Drugs. 2006;66(9):1169-1177 - "These trials have demonstrated an approximately 15-30% reduction in the new onset of diabetes in those receiving ACE inhibitors and ARBs when compared with placebo or other active therapy"
• ACE Inhibitors May Boost Birth Defects - WebMD, 6/7/06
• Blood Pressure Drugs Counter Cancer? - WebMD, 5/23/06 - "After crunching the numbers, the risk reduction in veterans taking ACE inhibitors was 53% for colon cancer, 52% for pancreatic cancer, and 46% for esophageal cancer"
• ACE Inhibitors and ARBs vs. Other Antihypertensives - Medscape, 3/9/06 - "When diabetics and nondiabetics were analyzed together, ACE inhibitors or ARBs were significantly more effective than other antihypertensives in reducing ESRD incidence, serum creatinine levels, and albuminuria, but they had no significant effect on preventing doubling of serum creatinine or reduction in GFR. In diabetics, ACE inhibitors or ARBs were significantly more effective than other antihypertensives only in reducing albuminuria; in nondiabetics, ACE inhibitors or ARBs were more effective than other agents only in reducing albuminuria and serum creatinine levels"
• Blood pressure control in eldery hypertension - Nippon Rinsho. 2006 Jan;64(1):75-80 - "Because ACE inhibitors/ARBs or Ca blockers increase insulin sensitivity, these drugs should be used as the first choice in cases of elderly hypertensive patients complicated with diabetes mellitus"
• Addition of an angiotensin receptor blocker to full-dose ACE-inhibition: controversial or common sense? - Eur Heart J. 2005 Nov;26(22):2361-7 - "combination of a full-dose ACE-inhibitor and an ARB can be a rational choice in selected patients" - [full article]
• ACE-Inhibitors Improve Outcomes in Coronary Artery Disease - Doctor's Guide, 11/15/05
• Ramipril Reduces C-reactive Protein and Endothelial Function - Doctor's Guide, 11/4/05
• Dyslipidemia and Concurrent Medications Improve Likelihood of Persistence to ACE Inhibitor Therapy - Doctor's Guide, 10/27/05 - "At 18 months, among patients in the primary prevention cohort, persistence rates were 57% for patients taking ramipril, 54% for those on fosinopril, 48% for quinapril, 47% for lisinopril and 45% for enalapril. In the secondary prevention cohort, the persistence rates were 62%, 53%, 52%, 50% and 47%, respectively ... The adjusted rate ratio of therapy discontinuation was consistently higher for all other ACE inhibitors relative to ramipril"
• Enalapril Better Suppresses Ventricular Remodeling - Medscape, 10/21/05
• A Debate on the Metabolic Syndrome: Evolving Challenges and Controversies - Medscape, exp. 8/31/07 - "Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are first-line treatments for hypertensive albuminurics with the metabolic syndrome"
• Angiotensin-converting enzyme inhibitors or Angiotensin receptor blockers for prevention of type 2 diabetes a meta-analysis of randomized clinical trials - J Am Coll Cardiol. 2005 Sep 6;46(5):821-6 - "ACE inhibitors and ARBs were associated with reductions in the incidence of newly diagnosed diabetes by 27% and 23%, respectively, and by 25% in the pooled analysis ... The use of an ACE inhibitor or ARB should be considered in patients with pre-diabetic conditions such as metabolic syndrome, hypertension, impaired fasting glucose, family history of diabetes, obesity, congestive heart failure, or coronary heart disease"
• Stabilization and Regression of Albuminuria in Chinese Patients With Type 2 Diabetes: A One-year Randomized Study of Valsartan Versus Enalapril - Adv Ther. 2005 Mar-Apr;22(2):155-62 - "enalapril and valsartan both reduced blood pressure and albuminuria to a similar extent ... Fewer adverse events were reported with valsartan"
• Comparison of the effects of ramipril versus telmisartan in reducing serum levels of high-sensitivity C-reactive protein and oxidized low-density lipoprotein cholesterol in patients with type 2 diabetes mellitus - Am J Cardiol. 2005 Jun 1;95(11):1386-8 - "All regimens were associated with a significant reduction of C-reactive protein and oxidized low-density lipoprotein cholesterol serum levels"
• Telmisartan Superior to Ramipril in Preventing Morning Blood Pressure Rise - Doctor's Guide, 5/19/05 - "Reductions were greater and statistically significant in the highest quartile (34 mmHg), in whom telmisartan reduced systolic surge by 12.4 mmHg and ramipril by 7.1 mmHg"
• Blood Pressure Linked to Erectile Dysfunction - WebMD, 5/16/05 - "Men on older high blood pressure medications (diuretics, beta-blockers) had higher rates and more severe erectile dysfunction than men on newer medications (calcium antagonists, ACE inhibitors, angiotensin II receptor blockers)"
• Blood Pressure Drug May Slow Alzheimer's - WebMD, 10/11/04 - "patients who took blood pressure pills known as ACE inhibitors showed a slower deterioration in thinking and memory than patients who took other types of high blood pressure drugs ... particularly Aceon and Capoten"
• ACE Inhibitors: Underused in Elderly Heart Failure Patients - Physician's Weekly, 9/6/04
• ACE Inhibitors Prevent Heart Attack, Stroke - WebMD, 9/6/04
• Cardiovascular Patients Taking Certain Medications Need Close Monitoring To Guard Against Dangerously High Potassium Levels - Science Daily, 8/17/04 - "Angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers are commonly used to treat hypertension ... A side effect to these therapeutics is hyperkalemia, or higher than normal levels of potassium in the bloodstream ... The development of hyperkalemia is a potentially life-threatening complication because it can disrupt the heart's normal rhythm"
• Blood Pressure Drug Shows Side Effects - HealthDay, 8/9/04 - "Angiotensin-converting enzyme (ACE) inhibitors may cause lip and tongue swelling in some people, resulting in trouble swallowing, shortness of breath, coughing and even respiratory failure"
• Lifesaving Drugs Underused in Heart Failure - WebMD, 8/3/04
• Not All ACE Inhibitors Have the Same Effect on Mortality - Medscape, 7/28/04 - "enalapril, fosinopril, captopril, quinapril, and lisinopril were associated with higher mortality than was ramipril. The adjusted hazard ratios were 1.47 (95% confidence interval [CI], 1.14 to 1.89), 1.71 (95% CI, 1.29 to 2.25), 1.56 (95% CI, 1.13 to 2.15), 1.58 (95% CI, 1.10 to 2.82), and 1.28 (95% CI, 0.98 to 1.67), respectively, and 0.98 (95% CI, 0.60 to 1.60) for perindopril"
• Antihypertensive Treatment with Captopril Associated with Lower Risk for Developing Diabetes than Conventional Therapy - Doctor's Guide, 4/19/04
• Potential Use of Statins and Angiotensin-Converting Enzyme Inhibitors to Treat Cardiac Syndrome X - Doctor's Guide, 1/20/04 - "A significant reduction in the number of chest pain episodes was observed with treatment, from 14 to 4.4 episodes after 6 months of therapy ... Exercise duration was 23.5% greater after atorvastatin plus ramipril treatment"
• ARB, ACE Inhibitor, or Both After MI in High-Risk Patients? - Medscape, 1/9/04
• Captopril May Lower Risk of Prostate Cancer - Doctor's Guide, 12/23/03 - "Captopril was associated with the smallest estimate of risk 0.7 (95% CI: 0.4-1.2), with the reduction in risk more apparent among short-term users than long-term users, and among patients taking less than 50 mg daily"
• Valsartan Shown as Effective as Captopril for Post-Heart Attack Treatment - Doctor's Guide, 11/10/03
• Two Heart Drugs [ARBs & ACE Inhibitors] Found Equally Effective - HealthDay, 11/10/03 - "Overall survival in both groups and among patients who got combined therapy was better than 80 percent ... The incidence of side effects such as cough, taste disturbance and rash was higher among those given both drugs together, and people getting the combined treatment were more likely to stop taking the medications ... valsartan is "a safe and equally effective alternative" for patients who have problems with ACE inhibitor treatment, Mann writes. People with kidney problems, for instance, are usually kept away from these drugs"
• Ramipril May Cause Prolonged Cholestatic Hepatitis and Biliary Cirrhosis - Doctor's Guide, 11/3/03 - "Angiotensin-converting enzyme (ACE) inhibitors are generally well tolerated and, while liver injury is rare, it has been reported in patients receiving captopril, enalapril, lisinopril, and fosinopril ... Ramipril-associated liver injury is similar to that seen with other ACE inhibitors, but liver biopsy findings of duct necrosis and extravasation of bile have not been reported previously"
• Amlodipine Besylate/Benazepril HCl Combination Works Best for Lowering Blood Pressure - Doctor's Guide, 10/12/03
• Telmisartan And Lisinopril Appear Equally Effective In Reducing Blood Pressure and Pulse Pressure - Doctor's Guide, 10/10/03 - "For both TPR and SI measurement techniques, no differences were detected between the two drugs in their effects on systolic and diastolic BP"
• Renin-Angiotensin System Blockade Produces Multiple Benefits Independent of Blood Pressure Reduction - Doctor's Guide, 9/29/03 - "According to the authors, ACE inhibitors and ARBs, at least in higher- or moderate-risk individuals, "show advantages that are additional to the reduction in blood pressure that they achieve ... We still await new and forthcoming data as to whether the better-tolerated ARBs have benefits equivalent to those of the ACE inhibitors, for which there are now numerous data ... We also await data on the combination of both these classes of drugs, particularly with respect to safety"
• ACE Inhibitors Before Bypass Surgery Linked to Lower Risk of Acute Thrombosis - Doctor's Guide, 9/29/03
• Diabetics Likely to Need More than ACE Inhibitors to Prevent Vascular Remodeling - Doctor's Guide, 9/29/03
• Drugs Blocking the Renin-Angiotensin System Offer Advantages Beyond Lowering Blood Pressure - Doctor's Guide, 9/15/03 - "According to the authors, ACE inhibitors and ARBs, at least in higher- or moderate-risk individuals, "show advantages that are additional to the reduction in blood pressure that they achieve"
• High Doses of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Required for Maximum Renoprotection - Doctor's Guide, 9/12/03 - "angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can have significant renoprotective effects, in addition to known antihypertensive benefits ... The optimal dose and strategy for renoprotection using ACEI and ARBs should be guided by titrating to the maximum antiproteinuric effect ... For patients who maintain elevated proteinuria despite high dose monotherapy, they recommend combined use of ACE inhibitors and ARBs"
• Heart Failure Drugs May Target Both Beta-Adrenergic and Angiotensin II Receptors - Medscape, 9/8/03 - "Beta-adrenergic receptors and angiotensin II type 1 receptors join to form receptor complexes, allowing single antagonist drugs used to treat heart failure to have a dual effect ... It's like getting two drugs for the price of one ... Because angiotensin blockers are better tolerated, they could be given alone to patients too sick to take beta-blockers" [HealthDay]
• Two Blood Pressure Drugs May Act as One - HealthDay, 9/8/03 - "The drugs are beta blockers, which act on receptors that control the amount of blood delivered to the body at times of stress, and angiotensin-converting enzyme (ACE) inhibitors, which act on receptors that regulate growth of heart muscle ... There has been evidence that these two receptors act as a pair"
• ACE Inhibitors Should Be Standard Heart Disease Treatment, Study Suggests - WebMD, 9/3/03 - "Every patient with coronary disease should be on aspirin, and most on a statin and one could argue, also a beta-blocker. Now, based on this important finding, an ACE inhibitor should be one of the top three or four drugs taken by every patient ... translates to a 20% reduced risk of problems from taking the ACE inhibitor"
• Blood Pressure Drug Eyed In Heart Study - Intelihealth, 9/2/03
• Patients on Perindopril Have 20% Reduced Mortality in EUROPA Trial - Doctor's Guide, 9/2/03 - "Patients with stable heart disease -- angina or a previous heart attack -- can reduce their relative risk of dying of heart disease by 20% if they take the angiotensin-converting enzyme (ACE) inhibitor perindopril ... We now have sufficient evidence to show that perindopril should be used to treat all patients with angina pectoris, history of heart attacks and other evidence of coronary disease, regardless of their hypertensive status"
• Renin-Angiotensin System Blockers Offers Added Benefits Beyond Blood-Pressure Lowering For Hypertensives - Doctor's Guide, 8/28/03 - "Emerging data on newer drugs that block the renin-angiotensin system, such as the angiotension II type 1 receptor blockers (ARBs) and angiotension-converting enzyme (ACE) inhibitors, indicate added benefits such as reduced mortality, strokes, and myocardial infarction along with decreased blood pressure"
• ACE Inhibitors Prevent Diabetes and Cardiovascular Disease by Multiple Mechanisms - Doctor's Guide, 7/25/03 - "ACE inhibitors inhibit the conversion of angiotensin I to angiotensin II ... Angiotensin II increases the production of reactive oxygen species and has several vasoconstrictive effects, including opposition of the vasorelaxant actions of nitric oxide and stimulation of plasminogen activator inhibitor-1 ... Angiotensin II, furthermore, increases arterial stiffness by a variety of mechanisms ... fewer studies have evaluated the effects of angiotensin receptor blockers (ARBs), although these agents may also exert beneficial effects and may act synergistically with ACE inhibitors ... The authors note that, regarding the role of ACE inhibitors in diabetic renal disease, with the exception of ARBs, ACE inhibitors "have been shown to be more effective in reducing proteinuria than any other antihypertensive agents."
• Questions Remain about Combination of AT-1 Antagonists with ACE Inhibitors for Renal Disease - Doctor's Guide, 7/18/03
• PROGRESS Trial Supports Use of Perindopril-Based Therapy for Preventing Secondary Stroke - Doctor's Guide, 7/4/03
• Enalapril Shows Renoprotective Effect in Diabetics with Microalbuminuria - Doctor's Guide, 6/18/03
• Perindopril/Indapamide Therapy May Help Reduce Dementia Risk In Patients With Cerebrovascular Disease - Doctor's Guide, 6/16/03
• Long-Term ACE Inhibitor Treatment Promotes Renal Health and Improved Lipid Profiles - Doctor's Guide, 6/12/03 - "In the group switched from a diuretic, the mean urinary albumin excretion was reduced from 37.0 to 23.2 at 12 months. In that same time period, the urinary albumin excretion decreased from 38.9 to 25.3 in the group switched from calcium channel blockers ... After switching to temocapril, serum total cholesterol in the switched groups was significantly decreased from the baseline value (P<0.05) -- from 223.5 mg/dL to 210.7 mg/dL in the group switched from diuretics; from 215.6 mg/dL to 209.3 mg/dL in the group switched from calcium channel blockers ... Serum levels of low-density lipoprotein and high-density lipoprotein were also improved in the switched groups"
• Enalapril Has Renoprotective Effect in Chronic Allograft Nephropathy - Doctor's Guide, 6/12/03
• Enalapril Therapy Improves Long-Term Survival In Patients With Left Ventricular Systolic Dysfunction - Doctor's Guide, 6/4/03
• Sildenafil Plus Angiotensin Converting Enzyme Inhibitor Improves Endothelial Function More Than Either Agent Alone - Doctor's Guide, 5/21/03
• Nocturnal Dosing of Graded-Release Diltiazem Tops Nocturnal Ramipril for Blood Pressure Control - Doctor's Guide, 5/20/03
• Angiotensin-Converting-Enzyme Strategy For Older Hypertensives Benefits Diabetics In Particular - Doctor's Guide, 5/16/03
• Long-Term Enalapril May Slow Disease Damage In Diabetics - Doctor's Guide, 4/28/03
• Perindopril May Be Better At Enhancing Bradykinin-Induced Coronary Release Of Tissue-Type Plasminogen Activator - Doctor's Guide, 4/28/03
• Altace (Ramipril) Reduces Heart Failure, Is Cost-Effective for Treatment of High-Risk Cardiovascular Patients - Doctor's Guide, 4/24/03
• Ramipril Reduces Advanced Glycation End Products In Non-Diabetic Nephropathy - Doctor's Guide, 4/21/03 - "Ramipril also mildly decreased levels of advanced glycation end products"
• Lisinopril/Nifedipine GITS Combination More Effective Than Either Drug Alone In Reducing Blood Pressure - Doctor's Guide, 4/1/03
• Reduced Diabetes With Enalapril In Heart Failure Patients - Doctor's Guide, 3/24/03
• High Blood Pressure Drug for Heart Failure - WebMD, 2/24/03 - "high-risk patients treated with a widely prescribed ACE inhibitor [Altace] were 23% less likely to develop heart failure than patients who were not treated ... ACE inhibitors work by widening the blood vessels to help improve blood flow. They also help block a blood vessel-constricting chemical called angiotensin, which is produced in people with heart disease and may cause worsening of the disease"
• Which Blood Pressure Drug Is Best? - HealthDay, 2/12/03 - "The differing results could have been due to the difference in the ethnic makeup of the two trials, Reid says. "Thirty percent of the ALLHAT subjects were black Americans, who are known not to respond to ACE inhibitors," ... Almost all the 6,083 people in the Australian trial were white. Blood pressure reduction was the same in those who took a diuretic and those who took an ACE inhibitor. The incidence of stroke was the same in both groups, but the number of deaths from cardiovascular disease was 11 percent lower in the ACE inhibitor group ... There is general agreement that almost all people with high blood pressure need to take to more than one drug"
• New Treatment Reduces Risks in Diabetics - WebMD, 1/29/03 - "Taking 50 mg of either Capoten or Cozaar to lower blood pressure"
• Blood Pressure Control -- Timing Matters - WebMD, 1/24/03 - "Researchers found that the diuretic and calcium-channel blocker were effective around the clock. The beta-blocker was the least effective of the four drugs overall and it had no effect on blood pressure during the night or in the early morning hours. ACE inhibitors actually worked best while the study participants were sleeping, but had little effect on blood pressure during the day"
• Angiotensin-Converting Inhibition Fails To Ward Off Retinopathy In Normotensive Diabetics - Doctor's Guide, 12/19/02
• Vasotec (Enalapril) Improves Long-Term Outcomes In Hypertensive Patients - Doctor's Guide, 12/17/02
• Angiotensin Receptor Blocker Plus Angiotensin Converting Enzyme Inhibitor Enhances Angiotensin II Blocking Effect - Doctor's Guide, 11/4/02
• Ramipril May Help Prevent Cardiovascular Events, Diabetes Among High Risk Patients - Doctor's Guide, 10/30/02
• ACE-Inhibitors May Improve Exercise Capacity In Congestive Heart Failure - Doctor's Guide, 10/15/02
• Efficacy of Angiotensin Converting Enzyme Inhibitors Not Altered By Aspirin - Doctor's Guide, 10/4/02
• Angiotensin-Converting Enzyme Inhibitors Increase Peripheral Vasodilatation And T-Pa Release - Doctor's Guide, 9/30/02
• Oral Contraceptive Can Boost Enalapril's Antihypertensive Effects In Postmenopausal Women - Doctor's Guide, 9/30/02
• Effective ACE-Inhibition Results in Better QOL and Reduction in Morbidity and Mortality - Doctor's Guide, 9/25/02
• Enalapril Sustains Survival in Left Ventricular Dysfunction - Doctor's Guide, 9/24/02
• Lisinopril But Not Losartan Boosts Myocardial Perfusion In Hypertensives With Left Ventricular Hypertrophy - Doctor's Guide, 9/18/02
• Aspirin May Negate the Benefits of ACE Inhibitors - Doctor's Guide, 9/13/02 - "Although aspirin (ASA) and angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce ischemic events after myocardial infarction (MI), ASA may attenuate the beneficial effects of ACE inhibitors among patients with CAD or left-ventricular dysfunction ... patients receiving an ACE inhibitor with ASA had a higher rate of death or recurrent MI compared to those receiving ASA alone ... Interestingly, the higher rate of adverse outcomes with this combination was present even in those receiving the 80 mg dose of ASA ... No mechanism for this adverse effect was suggested"
• Omapatrilat Better Than Enalapril for Blood Pressure but Increases Angioedema Risk - Doctor's Guide, 9/5/02
• Low-Dose Acetylsalicylic Acid may Interfere With ACE Inhibition in Type I Diabetics - Doctor's Guide, 9/4/02 - "Low-dose acetylsalicylic acid (ASA, Aspirin) may increase systolic blood pressure in type 1 diabetic patients, especially in those taking angiotensin-converting enzyme (ACE) inhibitors ... Compared to those not taking ASA, patients taking ASA had higher systolic blood pressure (SBP) (151 plus or minus 1 versus 134 plus or minus 1 mmHg; p<0.0001) and diastolic blood pressure (DBP) (84 plus or minus 1 versus 80 plus or minus 1 ... Similarly, in patients without CVD and not taking antihypertensive drugs (n=37), SBP was still higher in those taking ASA (142 plus or minus 3 mmHg) compared to the 1042 participants who were not taking it (128 plus or minus 1 mmHg)"
• Trandolapril plus Verapamil more effective than Trandolapril Alone in Type 2 Diabetics - Doctor's Guide, 9/3/02
• Long-Term Outcome Favourable for Enalapril in Proteinuric IgA Nephropathy Patients - Doctor's Guide, 7/22/02
• Patient Compliance with Antihypertensive Therapy Appears Longer for Those Taking Angiotensin II Antagonists - Doctor's Guide, 7/18/02 - "The researchers found that the class of drug had a statistically significant effect on the patients' persistence of compliance. Angiotensin II antagonists had the highest rate of persistence followed by ACE inhibitors, calcium channel blockers, beta-blockers, and diuretics"
• Administration Timing Influences Antiproteinuric Effect of ACE Inhibitor Trandolapril - Doctor's Guide, 7/18/02
• New Formulation Of Lotrel (Amlodipine/Benazepril), 10/20 mg, Now Available - Doctor's Guide, 7/15/02
• Low-Dose Aspirin Does Not Interfere With Antihypertensive Agents - Doctor's Guide, 6/4/02
• Perindopril Controls High Blood Pressure in Diabetics - Doctor's Guide, 5/19/02
• Combination of Amlodipine/Benazepril Reduces Edema, Controls Blood Pressure After Monotherapy Failure - Doctor's Guide, 5/19/02
• Perindopril Erbumine Effective in Elderly Hypertensives - Doctor's Guide, 5/17/02
• ACE-inhibitors Reduce Ventricular Depolarization in Congestive Heart Failure Patients - Doctor's Guide, 4/16/02
• Combination ACE Inhibitors and Angiotensin II Blockers Decreases Proteinuria in Patients with Diabetic Nephropathy - Doctor's Guide, 4/11/02
• Significant Stroke Prevention Noted With Ramipril - Doctor's Guide, 3/21/02
• ACE Inhibitors May Delay Disability in Elderly Women - Medscape, 3/21/02
• Keeping Seniors Independent - WebMD, 3/14/02 - "the average three-year decline in walking speed among those women who used ACE inhibitors was 10 times lower than it was in the other groups ... Researchers think several factors may explain these drugs' beneficial effect on delaying disability: ACE inhibitors increase blood flow to the muscles, reduce inflammation, and promote healthy eating habits and better nutrition by inhibiting a substance known to reduce appetite"
• ACE Inhibitors Slows Muscle Decline In Older Women - Doctor's Guide, 3/14/02 - "Women who were continuous users of ACE inhibitors had a lower average three year decline in muscle strength of 1 kg compared with a decline of 3.7 kg in continuous/intermittent users of other antihypertensive drugs. Women who had never used antihypertensive drugs had an average decline in muscle strength of 3.9 kg"
• Ramipril Reduces Stroke Risk, HOPE Trial Follow-up Reports - Doctor's Guide, 2/11/02
• Losartan/Quinapril Combination Therapy Suppresses Cardiac Sympathetic Activity - Doctor's Guide, 1/29/02
• Blood Pressure Drugs May Help People Avoid 'Type 2' Disease, but Healthy Habits Still Best - WebMD, 10/16/01 - "people at high risk for developing diabetes who take the drug Altace [ramipril] were 34% less likely to develop diabetes than those who did not get the drug ... for patients with type 2 diabetes, the most significant complications in terms of the time spent in hospitals and death are ... problems like heart attack and stroke ... The study's primary focus was to determine if taking Altace, a type of drug called an ACE inhibitor, prevented heart attacks in people at high risk for having one ... As hoped, significant reductions in deaths from heart attack, strokes, or other cardiovascular diseases were seen among participants taking the ACE inhibitor. But the reduction in diabetes incidence was unexpected"
• Altace (Ramipril) Reverses Heart Enlargement/Cuts Cardiovascular Risk - Doctor's Guide, 10/2/01
• Blood Pressure Combo [ACE inhibitor & diuretic] Lowers Risk of Stroke - WebMD, 9/27/01
• Angiotensin Converting Enzyme Inhibitor-Induced Angioedema Associated With Low Enzyme Levels - Doctor's Guide, 9/23/01
• On an ACE Inhibitor? You Don't Have to Cough Up a Lung - WebMD, 8/16/01
• ACE Inhibitor Plus Diuretic Combo Best for American Indians - Doctor's Guide, 7/11/01
• Low-Dose Perindopril/Indapamide Combination More Effective Than Irbesartan Alone - Doctor's Guide, 6/21/01
• Quinopril and L-Arginine Improves Endothelial Function In Hypertensive Patients - Doctor's Guide, 6/21/01
• Amlodipine, Fosinopril have Equivalent Effects on Left Ventricular Hypertrophy and Urinary Albumin Excretion - Doctor's Guide, 6/20/01
• Candesartan Shown Equivalent To Enalapril In Regressing Left Ventricular Hypertrophy - Doctor's Guide, 6/19/01
• Blood Pressure Drugs Cut Stroke Risk - Intelihealth, 6/17/01 - "giving stroke patients blood pressure pills and diuretics could halve the chance of their suffering another stroke"
• Weighing In on Kidney Disease Linked to Obesity, Researchers Warn of 'Newly Emerging Epidemic' - WebMD, 4/26/01 - ""It's well established that obesity is related to diabetes -- in fact 80% of diabetics are type 2, and those are almost all people who are at least overweight if not obese. And then we've shown in the past eight or nine years that ... in normal healthy individuals blood pressure goes up ... with a fairly substantial increase in weight, and if you lose weight blood pressure comes back down. The contention is that over a period of time there's going to be a detriment to the kidneys," ... in at least some cases the proteinuria seen in people with ORG can be halted or reversed with weight loss and/or the use of blood-pressure lowering drugs called ACE-inhibitors"
• ACE Scores High In Diabetic Hypertension - Intelihealth, 4/20/01 - "hypertension is twice as frequent in diabetics, and up to 75 percent of CVD cases in people with diabetes may be attributable to hypertension ... suggest that ACE inhibitor therapy may improve insulin sensitivity and also delay the development of diabetes in patients at high risk ... Rigorous control of blood pressure to less than 130 millimeters of mercury (mmHg) systolic and 85 mmHg diastolic strikingly decreases heart attacks, strokes and end-stage renal disease in diabetic patients"
• ACE Inhibitor Drugs Called Best Weapon in Fight Against Heart Disease and Diabetes - WebMD, 4/19/01
• Blood Pressure Drug Appears to Prevent Migraines, May Work as Well as Other Migraine Drugs Currently Available - WebMD, 1/5/01 - "In nearly a third of the patients, symptoms were reduced by half while on lisinopril. These patients also had fewer overall days with migraine."
• Angiotensin-converting Enzyme Inhibitors, Beta Blockers May Postpone Kidney Failure - Doctor's Guide, 10/13/00 - "The ACE inhibitor ramipril (Altace®) or the beta-blocker metoprolol (Toprol®) significantly reduced the risk of kidney failure compared to the CCB amlodipine (Norvasc®) in a group of patients who had at least one gram of protein in a 24-hour sample of urine when they joined the African American Study of Kidney Disease and Hypertension (AASK). Blood pressures were comparable."
• Atacand(Candesartan) Effective Antihypertensive, More Tolerable Than Norvasc(Amlodipine) - Doctor's Guide, 5/19/00
• Unique Mechanism of Action of Omapatrilat May Offer Benefit Over Antihypertensive Lisinopril - Doctor's Guide, 5/19/00 - "Omapatrilat demonstrated greater reduction in blood pressure than the ACE inhibitor lisinopril in individuals with salt-sensitive hypertension who typically do not respond well to ACE inhibitors."
• Study Finds ACE Inhibitor Quinapril Effective For Opening Blood Vessels - Doctor's Guide, 1/3/00
• Aceon® Tablets Available In U.S. For 24-Hour Control of Hypertension - Doctor's Guide, 10/7/99
• Zestril (Lisinopril) Helps Damaged Hearts Start To Repair Themselves - Doctor's Guide, 9/19/00 - "Damaged hearts of patients suffering from heart failure actually start to repair themselves when treated with the ACE inhibitor Zestril (lisinopril), according to a new study published this week’s in Circulation."
• Newer And Older Hypertensive Treatments Equally Effective In The Elderly - Doctor's Guide, 11/19/99
• Losartan Doesn’t Unseat Reigning Therapy For Heart Failure - Doctor's Guide, 11/11/99 - "The angiotensin II receptor blocker losartan (Cozaar) did not outperform gold-standard ACE inhibitor therapy in the treatment of heart failure in a large, randomized trial, following a smaller trial that suggested it might be more effective."
• Aldactone And ACE Inhibitor Regimen Reduces Heart Failure Deaths By 30% - Doctor's Guide, 9/2/99 - "Not only was combination therapy with Aldactone and ACE inhibitors well tolerated by patients in the most severe stages of heart failure, but the decrease in cardiac death and hospitalisation was dramatic, said lead investigator Bertram Pitt, M.D., professor in the division of cardiology at the U-M Medical School. These findings suggest that the gold standard treatment for severe heart failure should include an aldosterone receptor antagonist."
• ACE Inhibitor Could Prevent One Million Events, Research Shows - Doctor's Guide, 8/31/99
• ACE Inhibitor Improves Life Expectancy After Heart Attack - Doctor's Guide, 7/2/99
• HOPE Study Indicates Altace Could Save One Million Lives Each Year - Doctor's Guide, 5/12/99
• High Doses Of Zestril May Extend Life In Heart Failure Patients - Doctor's Guide, 3/30/98
• How To Stop ACE Inhibitor-Induced Cough - Doctor's Guide, 7/4/97 - "When picotamide was given to nine patients with ACE-inhibitor-induced cough, eight reported that the cough disappeared less than three days after they started picotamide."