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ACE-Inhibitors Score High In Reducing Heart Attack Deaths

DALLAS, June 9 -- A type of drug that lowers high blood pressure improves a person's odds of surviving after a heart attack, say researchers reporting on a study of nearly 100,000 heart attack patients that appears in today's Circulation: Journal of the American Heart Association.

The drugs, called an ACE (angiotensin-converting enzyme) inhibitors, interfere with the body's production of a chemical called angiotensin that causes the blood vessels to constrict. When blood vessels widen, blood pressure is lowered. The study found that for every 1,000 individuals treated, five lives were saved after 30 days, says Maria Grazia Franzosi, Ph.D., a pharmacologist at the Istituto di Ricerche Farmacologiche "Mario Negri" in Milan, Italy, who led the collaborative analysis.

"For most individuals, ACE-inhibitor therapy may be started immediately -- during the first few hours of a heart attack," she says. "Most of the benefit appears early, in the first few days, when the risk of death is highest." In an accompanying editorial in the journal, Marc A. Pfeffer, M.D., Ph.D., of the cardiovascular division of Brigham and Women's Hospital at Harvard Medical School in Boston, writes, "ACE-inhibitors have earned their place" along with aspirin and drugs such as beta-blockers and thrombolytic therapies proven to reduce deaths from heart attack.

Thrombolytic, or "clot-busters" and aspirin break up blood clots that can obstruct the blood vessels leading to the heart, while beta-blockers and ACE-inhibitors relax the blood vessels.

On the downside, ACE-inhibitors nearly doubled the risk of low-blood pressure episodes. The rate of such episodes was 17.6 percent in the drug-treated group and 9.3 percent in the control group of patients who were not treated with the drug. Those taking the drug also had double the rate of kidney problems: 1.3 percent in the drug group versus 0.6 percent in controls. The researchers lack data on whether those conditions improved when trea
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Contact: Carole Bullock
caroleb@amhrt.org
214-706-1279
American Heart Association
8-Jun-1998


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