Angiotensin-Converting Enzyme Inhibitors: Do We Utilize Our Knowledge in Heart Failure Patients?

Journal of Clinical and Basic Cardiology 2001; 4 (4): 279-283

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Keywords: ACE-Hemmer,  Herzinsuffizienz,  Mortalität,  remodelling,  angiotensin-converting enzyme inhibitors,  heart failure,  mortality,  remodelling

Recently, the problem of heart failure (HF) has become a topic of great interest. The use of angiotensin-converting enyzme inhibitors (ACEIs) in HF patients is considered nowadays as one of the important and necessary steps towards an optimal treatment of these patients. Even though most of the big studies have proved the great beneficial effects of these agents they are still underused and not applied in the recommended doses for HF patients. We have studied the use of ACEIs among HF patients in the 1st Internal department of the University Hospital of Bratislava. We observed that in the period between January-September 1997, 70 % of HF patients admitted to the department were treated with ACEIs. Only in 17 % of patients was there an acceptable reason for withholding the treatment. In most of patients who used ACEIs low doses had been prescribed, and in only 4 % of them recommended doses have been given. Just in 15 % of these patients was there a convincing reason for underdosing these agents. It seems prudent to emphasize that ACEIs should be administered in recommended doses in all HF patients unless there is a contraindication to their use.