Effects of angiotensin-converting enzyme inhibitors beyond lowering blood pressure - Are they important for doctors?

Large clinical trials and experimental studies have indicated that not all of the beneficial properties of angiotensin-converting enzyme inhibitors (ace-is) can be attributed to the lowering of blood pressure. the aim of this study was to assess doctors' opinions about the importance of the cardioprotective effects of ace-is beyond lowering blood pressure. the study participants (685 physicians) filled in a questionnaire testing doctors'knowledge of all of the therapeutic effects of ace-is not directly associated with lowering blood pressure and their clinical importance. in addition,each doctor filled in 20 questionnaires for subsequent patients treated with any ace-i. fifty-nine percent of the investigated physicians were aware of most of the therapeutic effects of ace-is. the most important therapeutic effects for the respondents were the following: reduction of peripheral resistance,inhibition of left ventricle hypertrophy,inhibition of vascular remodeling and atherosclerotic plaque stabilization. the most commonly prescribed ace-is were perindopril,lisinopril and chinalapril for inhibition of left ventricular hypertrophy and perindopril,ramipril and chinalapril for inhibition of arterial wall remodeling. the ace-is that were used to reduce peripheral vessel resistance included perindopril,lisinopril and trandolapril. drugs used to stabilize the plaque included perindopril,lisinopril and cilazapril. the therapeutic effects of ace-is beyond lowering blood pressure were considered to be valid and important in daily clinical practice for the prevention of cardiovascular diseases and diabetic complications. the attribution of the effects of a particular ace-i was not always in accordance with evidence-based medicine. the obtained treatment outcomes were attributed to the entire group of ace-is. copyright © 2011 by institute of pharmacology polish academy of sciences.