Use of Angiotensin-Converting Enzyme Inhibitors in Heart Failure and Renal Insufficiency
Authors: Ali Ahmed
Journal: Annals of Internal Medicine (2004)

Letters1 June 2004Use of Angiotensin-Converting Enzyme Inhibitors in Heart Failure and Renal InsufficiencyAli Ahmed, MD, MPHAli Ahmed, MD, MPHFrom University of Alabama at Birmingham, Veterans Affairs Medical Center, and Alabama Quality Assurance Foundation, Birmingham, AL 35294-2041.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-11-200406010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We agree with Shlipak (1) that it is difficult to determine the efficacy of angiotensin-converting enzyme (ACE) inhibitors in patients with heart failure and renal insufficiency on the basis of subgroup analysis of data from randomized, controlled trials of ACE inhibitors in heart failure. However, data from retrospective follow-up studies suggest that ACE inhibitors are equally or more beneficial in patients with heart failure and renal insufficiency (2-4). Our group has demonstrated that use of ACE inhibitors was associated with lower 1-year mortality rates in patients with heart failure and perceived contraindications to ACE inhibitors (adjusted hazard ...References1. Shlipak MG. Pharmacotherapy for heart failure in patients with renal insufficiency. Ann Intern Med. 2003;138:917-24. [PMID: 12779302] LinkGoogle Scholar2. Ahmed A, Kiefe CI, Allman RM, Sims RV, DeLong JF. Survival benefits of angiotensin-converting enzyme inhibitors in older heart failure patients with perceived contraindications. J Am Geriatr Soc. 2002;50:1659-66. [PMID: 12366619] CrossrefMedlineGoogle Scholar3. Frances CD, Noguchi H, Massie BM, Browner WS, McClellan M. Are we inhibited? Renal insufficiency should not preclude the use of ACE inhibitors for patients with myocardial infarction and depressed left ventricular function. Arch Intern Med. 2000;160:2645-50. [PMID: 10999979] CrossrefMedlineGoogle Scholar4. Philbin EF, Santella RN, Rocco TA. Angiotensin-converting enzyme inhibitor use in older patients with heart failure and renal dysfunction. J Am Geriatr Soc. 1999;47:302-8. [PMID: 10078892] CrossrefMedlineGoogle Scholar5. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, et al . ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2001;38:2101-13. [PMID: 11738322] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Ali Ahmed, MD, MPHAffiliations: From University of Alabama at Birmingham, Veterans Affairs Medical Center, and Alabama Quality Assurance Foundation, Birmingham, AL 35294-2041.Grant Support: Dr. Ahmed is supported by a National Institute of Health Mentored Patient-Oriented Research Career Development Award (1-K23-AG19211-01). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPharmacotherapy for Heart Failure in Patients with Renal Insufficiency Michael G. Shlipak Use of Angiotensin-Converting Enzyme Inhibitors in Heart Failure and Renal Insufficiency Michael G. Shlipak Metrics Cited byA propensity score analysis of the impact of angiotensin-converting enzyme inhibitors on long-term survival of older adults with heart failure and perceived contraindications 1 June 2004Volume 140, Issue 11Page: 931-932KeywordsACE inhibitorsAdjusted odds ratioAttentionCareers in researchCreatinineDeath ratesHazard ratioHeart failureLongitudinal studiesRenal failure ePublished: 1 June 2004 Issue Published: 1 June 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...