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Thursday, 9th September 2004

New results show Altace to beneficial to people at high risk of heart attacks and stroke.

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  ACE inhibitors
Cardiac arrest
Sudden cardiac death

Altace was found to lower the risk of sudden cardiac death and nonfatal cardiac arrest in people at high risk of heart attacks and stroke.

Altace (Rimipril) belongs to a class of drugs known as Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are widely prescribed to patients following heart attacks and for those with heart failure. They are also recommended for people with high blood pressure, diabetes, and others at risk for ACE inhibitors and stroke.

Altace blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased blood pressure, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.

Past studies have shown that these medications reduce the risk of heart attack and stroke in people with heart disease.

The HOPE Trial

The Heart Outcomes Prevention Evaluation (HOPE) study followed a total of 9,297 high-risk patients who were aged 55+ either with a history of coronary artery disease (CAD), stroke, or peripheral vascular disease (PVD) or with diabetes plus at least one other cardiovascular risk factor (hypertension, elevated total cholesterol level, low high-density lipoprotein cholesterol level, cigarette smoking, or documented microalbuminuria.

The double blind, randomized study compared Altace with vitamin E or placebo treatment. Researchers now report that after an average of 4.5 years of treatment, 3% of the patients taking the ACE inhibitor had died from sudden cardiac death or experienced a nonfatal cardiac arrest, compared with 4% taking placebo. This translates into a 21% reduction in unexpected deaths, deaths due to cardiac arrest, or nonfatal cardiac arrest for those taking Altace.

In the HOPE study, roughly three out of four patients were also taking a blood thinner, a third were taking cholesterol-lowering statins, half were taking calcium channel blockers (another type of high blood pressure medication), and two out of five were taking beta-blockers. Thus showing that even when people were on other medications, they benefited from being on an ACE inhibitor.

These results stressed the importance in prescribing ACE inhibitors to patients at high risk of developing heart disease and stroke.


Teo et al. Circulation, Sept. 14, 2004.

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