Patients with chronic kidney disease (CKD) and HTN: Patients with an in-office or out-of-office BP exceeding 130 mmHg systolic or over 80 mmHg diastolic and the addition of the following factors:ģ.Patients with daytime BP out of the office at greater than 135 mmHg systolic or greater than 85 mmHg diastolic this is substitutable with office blood pressure readings of over 140/90 mmHg.According to the American College of Cardiology, treatment recommendations exist based on various patient populations. Hypertension guidelines recommend initiating ACE inhibitors to manage HTN to lower blood pressure (BP). ACE inhibitors can be used to treat hypertension (HTN) either alone or in conjunction with other antihypertensives in adults or children over six years old. HF guidelines recommend ACE inhibitors to help prevent HF in patients with a reduced ejection fraction (EF) who also have a history of myocardial infarction (MI), and to prevent HF in any patient with a reduced ejection fraction (EF), or to treat patients with heart failure and reduced EF.Ģ. Angiotensin-converting enzyme (ACE) inhibitors are useful as adjunctive therapy in systolic heart failure (HF). Review interprofessional team approach using evidence-based medicine and patient-centered approach to improve patient outcomes.ġ.Outline the classic indications for initiating ACE inhibitor therapy. ![]() Summarize the adverse effects of ACE inhibitors.Identify the mechanism of action of ACE inhibitors.This activity reviews the indications, contraindications, mechanism of action, adverse events, and other key elements of ACE inhibitor therapy in the clinical setting related to the essential points needed by members of an interprofessional team managing the care of patients with hypertension and its related conditions and sequelae. Most cases are primary and not attributable to any specific etiology. Prescribing the least expensive ACE inhibitor in lower doses will lead to substantial cost savings, and possibly a reduction in dose-related adverse events.ACE inhibitors are a medication class used to treat and manage hypertension, a significant risk factor for coronary disease, heart failure, stroke, and a number of other cardiovascular conditions. Due to incomplete reporting of the number of participants who dropped out of the trials due to adverse drug reactions, as well as the short duration of these trials, this review could not provide a good estimate of the harms associated with this class of drugs. This could mean that the drug companies are withholding unfavorable findings related to their drugs. Most of the trials in this review were funded by companies that make ACE inhibitors and serious adverse effects were not reported by the authors of many of these trials. No ACE inhibitor drug appears to be any better or worse than others in terms of blood pressure lowering ability. Most of the blood pressure lowering effect (about 70%) can be achieved with the lowest recommended dose of the drugs. There was an 8-point reduction in the upper number that signifies the systolic pressure and a 5-point reduction in the lower number that signifies the diastolic pressure. The blood pressure lowering effect was modest. The trials followed participants for approximately 6 weeks (though people are typically expected to take anti-hypertension drugs for the rest of their lives). These trials evaluated the blood pressure lowering ability of 14 different ACE inhibitors in 12 954 participants. We found 92 trials that randomly assigned participants to take either an ACE inhibitor or an inert substance (placebo). The available scientific literature was searched to find all the trials that had assessed this question. ![]() We asked how much this class of drugs lowers blood pressure and whether there is a difference between individual drugs within the class. This class includes drugs such as ramipril (brand name: Altace), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril) and quinapril (Accupril). The class of drugs called ACE inhibitors is commonly used for the treatment of elevated blood pressure.
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