angiotensin converting enzyme inhibitors
DISEASE INTERVENTION COMPARISON RESULTS
J Card Fail. 2010 Mar;16(3):260-7 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
renin-angiotensin system inhibitors, angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB)
As Treatment, Chronic
Is equal Than
placebo
To reduce hospitalizations for heart failure or all-cause mortality.
Heart. 2017 Aug 5. pii: heartjnl-2017-311652. doi: 10.1136/heartjnl-2017-311652. [Epub ahead of prin Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, aldosterone blockers, spironolactone
As Treatment, Chronic
Is equal Than
placebo
To modify survival (except beta blockers, associated with reduced all-cause and cardiac deaths, (RR: 0.78) or reduce rehospitalizations or improve functional capacity
Heart. 2017 Aug 5. doi: 10.1136/heartjnl-2017-311652. [Epub ahead of prin Systematic Review
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, others
As Treatment, Chronic
Is equal Than
placebo ou usual care without those treatments
To modify mortality, with the exception of beta-blockers (RR 0.78). Trend to improve, but non consistent results, exercise capacity and quality of life
J Am Coll Cardiol. 2011 Apr 19;57(16):1676-86 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, others
As Treatment, Chronic
Is better Than
placebo ou usual care without those treatments
To improve excercise tolerance (51 to 61 more seconds on treadmill excercise test) but not heart fonction (E/A ratio) nor mortality
Eur Heart J. 2006 Oct;27(19):2338-45 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), elder patients The Use of
angiotensin converting enzyme inhibitors (ACEI), perindopril
As Treatment, Chronic
Is better Than
placebo
To reduce at 1 year hospitalizations for heart failure (HR 0.63) and improve functional class. However, differences in primary combined outcome at 2 years were not significant
Lancet. 2000 May 6;355(9215):1575-1581 Meta-Analysis
IN heart failure, chronic, systolic The Use of
angiotensin converting enzyme inhibitors (ACEIs)
As Treatment, Chronic
Is better Than
placebo
To reduce at 3 years death (23% ACEI VS 27% placebo), reinfarction or rehospitalisation
Lancet. 2003 Sep 6;362(9386):767-71 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic The Use of
angiotensin II receptor blockers (candesartan), added to angiotensin converting enzyme inhibitors
As Treatment, Chronic
Is better Than
angiotensin converting enzyme (ACE) inhibitors alone
To reduce, at 3.5 years, cardiac events (cardiac death or hospital admission for heart failure): 38% with sartan added VS 42% with AECI alone
Lancet. 2003 Sep 6;362(9386):772-6 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic The Use of
angiotensin II receptor blockers (candesartan), as sustitute of non tolered angiotensin converting enzyme inhibitors
As Treatment, Chronic
Is better Than
placebo
To reducing combined outcome cardio-vascular death or hospital admission for heart failure (33% in intv. / 40% in cont. in 34 months)
BMJ. 2009 May 19;338:b1665. doi: 10.1136/bmj.b1665 Meta-Analysis
IN hypertension, primary The Use of
5 main classes of blood pressure lowering drugs: thiazides, beta blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers
As Treatment, Chronic
Is better Than
placebo
To Prevent cardiac ischemic events, heart failure and stroke. Beta-blockers prevent better cardiac ischemis events after a myocardial infarction. Calcium antagonist had a marginal advantage for preventing stroke.
N Engl J Med. 2003 Feb 13;348(7):583-92 Randomized Controlled Trial, Multicenter Study
IN hypertension, primary The Use of
angiotensin converting enzyme inhibitors
As Treatment, Chronic
Is equal Than
diuretics
To cardiovascular events or deaths from any cause: 56.1 per 1000 patient-years in the ACE-inhibitor group / 59.8 per 1000 patient-years in the diuretic group (statiscally significative reduction)
Eur Heart J. 2012 Aug;33(16):2088-97 Meta-Analysis
IN hypertension, primary The Use of
angiotensin converting enzyme inhibitors (ACEI)
As Treatment, Chronic
Is better Than
placebo, and probably better than angiotensin II receptor blockers (ARBs)
To reduce all-cause mortality (20.4 deaths per 1000 patient-years with ACEIs VS 24.2 placebo). No significant mortality reduction appeared with ARB treatment
Lancet. 2000 Dec 9;356(9246):1955-64 Meta-Analysis
IN hypertension, primary The Use of
angiotensin converting enzyme inhibitors, calcium channel blockers
As Treatment, Chronic
Is better Than
placebo
To reducing major cardiovascular events
Cochrane Database Syst Rev. 2018 04 18;4(00000):CD001841 Systematic Review, Cochrane Review
IN hypertension, primary The Use of
low-dose thiazide diuretics, angiotensin converting enzyme inhibitors (ACEI), and calcium channel blockers
As Treatment, Chronic
Is better Than
high-dose thiazide diuretics, beta blockers
To reduce all-cause mortality, stroke and cardiovascular events
N Engl J Med. 2008 May 1;358(18):1887-98 Randomized Controlled Trial, Multicenter Study
IN hypertension, primary, elder patients The Use of
diuretic, indapamide, plus, if needed, angiotensin converting enzyme inhibitors (ACEI), perindopril
As Treatment, Chronic
Is better Than
placebo
To reduce mortality, cardiovascular mortality and stroke (absolute risk reduction not reported in abstract)
Ann Intern Med. 2001 Jul 17;135(2):73-87 Meta-Analysis
IN kidney disease, chronic, non diabetic The Use of
angiotensin converting enzyme inhibitors (ACEI)
As Treatment, Chronic
Is better Than
antihypertensive regimens not including ACEI
To reduce progression to end-stage renal failure (RR 0.7). The higher the uninary protein excrection, the higher the benefit.
Lancet. 1999 Jul 31;354(9176):359-64 Randomized Controlled Trial
IN kidney disease, chronic, non diabetic The Use of
angiotensin converting enzyme inhibitors (ACEI), ramipril
As Treatment, Chronic
Is better Than
placebo plus conventional antihypertensive therapy
To reduce progression to end-stage renal failure: 9% ACEI VS 20% controls
J Am Soc Nephrol. 2007 Jun;18(6):1889-1898. Epub 2007 May 9 Randomized Controlled Trial
IN kidney disease, chronic, with proteinuria, non diabetic The Use of
uptitration to maximal doses of angiotensin converting enzyme inhibitors (ACEI, benazepril ) or angiotensin II receptor blockers (ARB, losartan)
As Treatment, Chronic
Is better Than
usual doses of both drugs
To reduce, at 3.7 years, doubling creatinine or end-stage renal failure.
Lancet. 2001 Sep 29;358(9287):1033-41 Randomized Controlled Trial, Multicenter Study
IN stroke, hypertension, primary, non-hypertensive patients The Use of
angiotensin converting enzyme inhibitors (perindopril, 4 mg/d), plus discretional indapamide
As Prevention, Secondary
Is better Than
placebo
To reduce stroke (either ischemic or haemorrhagis) at 4 years: 10% with perindopril VS 14% with placebo. Also, it reduced major vascular events, but not mortality.