angiotensin-converting enzyme inhibitor


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angiotensin-converting enzyme (ACE) inhibitor

a protease inhibitor found in serum that promotes vasodilation by blocking the formation of angiotensin II and slowing the degradation of bradykinin and other kinins. It decreases sodium retention, water retention, blood pressure, and heart size and increases cardiac output.

ACE inhibitor

Angiotensin-converting enzyme inhibitor. Any of a family of drugs used to manage hypertension and reduce congestive heart failure (CHF)-related mortality and morbidity.

Examples
Bepridil, captopril, enalapril, lisionopril, losartan, quinapril, ramipril.

ACE inhibitor Effects in Heart Disease
Cardioprotective effects
• Restores balance between myocardial O2 supply and demand;
• Reduces left ventricular preload and afterload;
• Reduces left ventricular mass;
• Reduces sympathetic stimulation.
Vasculoprotective effects
• Antiproliferative and antimigratory effects on smooth muscle and inflammatory cells;
• Antiplatelet effects;
• Improved arterial compliance and tone;
• Improved and/or restored endothelial function;
• Antihypertensive;
• Possible antiatherosclerotic effect. 

Pros
ACEIs are cardioprotective and vasculoprotective; cardioprotective effects include improved haemodynamics and electric stability, reduce sympathetic nervous system (SNS) activity and reduce left ventricular mass; vasculoprotective benefits include improved endothelial function, vascular compliance and tone, and direct antiproliferative and antiplatelet effects. ACEIs also stimulate prostaglandin (PG) synthesis, reduce the size of MIs, and reduce reperfusion injury and complex ventricular arrhythmias.

ACEIs are the treatment of choice in CHF with systolic dysfunction; they are vasodilators which decrease preload and afterload. ACEI-induced reduction in angiotensin II inhibits the release of aldosterone, which in turn reduces sodium and water retention which, by extension, reduce preload; ACEIs improve haemodynamics of CHF by reducing right atrial pressure, pulmonary capillary wedge pressure, arterial BP, as well as pulmonary and systemic vascular resistance; ACEIs increase cardiac and stroke indices by the left ventricle and reduce the right ventricular end-diastolic volumes, thereby increasing cardiac output, while simultaneously reducing cardiac load and myocardial O2 consumption.
 
Adverse effects
• Idiopathic—e.g., rashes, dysgeusia, BMsuppression.
• Class-specific—e.g., hypotension, renal impairment, hyperkaleamia, cough, angioneurotic oedema (the latter 2 of which are mediated by small vasoactive substances—e.g., bradykinin, substance P, and PG-related factors).

Angiotensin-converting enzyme (ACE) inhibitor

A drug that relaxes blood vessel walls and lowers blood pressure.

angiotensin-converting enzyme inhibitor

; ACE inhibitor pharmacological agent preventing conversion of angiotensin I to angiotensin II (thereby controlling vasoconstriction and reducing blood pressure), used in the treatment of heart failure, hypertension (especially diabetic patients with associated nephropathy) and in the long-term management of patients with myocardial infarction; used with care in patients on diuretics and those with renal dysfunction
References in periodicals archive ?
Several studies have noted that angiotensin-converting enzyme inhibitors (ACEIs) can delay the progression of renal impairment in patients with type 2 diabetes.
Pourmoghaddas, "The role of diuretics and angiotensin-converting enzyme inhibitors on contrast-induced nephropathy in patients after percutaneous coronary intervention," Journal of Isfahan Medical School, vol.
Pharmacogenetic interactions between angiotensin-converting enzyme inhibitor therapy and the angiotensin-converting enzyme deletion polymorphism in patients with congestive heart failure.
2% of residents with congestive heart failure were not receiving an angiotensin-converting enzyme inhibitor.
Fosinopril, an angiotensin-converting enzyme inhibitor marketed as Monopril by Bristol-Myers Squibb, was granted "pediatric exclusivity" in January 2003, Under The Best Pharmaceuticals for Children Act, exclusivity is granted to companies who perform pediatric studies of their products in exchange for a 6-month extension on the drug's patent.
Juan Leon, from the same laboratory (NWU), showed that captopril, an antifibrotic angiotensin-converting enzyme inhibitor, is effective in ameliorating experimental autoimmune myocarditis and experimental Chagas heart disease.
Is optimal angiotensin-converting enzyme inhibitor dosing neglected in elderly patients with heart failure?
Angiotensin-converting enzyme inhibitor (ACE-I) angio-oedema was considered, [2-5] as ACE-I angio-oedema may develop months or even years after commencing therapy.
Prognostic impact of angiotensin-converting enzyme inhibitor therapy in diastolic heart failure.
The aim of this study was to elucidate the combined effect of the clinically used vitamin K(2) (VK) and angiotensin-converting enzyme inhibitor (ACE-I) on cumulative recurrence after curative treatment on a total of 87 patients, especially in consideration of neovascularization.

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