Addition of Angiotensin-Converting Enzyme Inhibitors to Beta-Blockers Does Not Have a Distinct Effect on Hispanics Compared With African Americans and Whites With Heart Failure and Reduced Ejection Fraction

2015 ◽  
Vol 21 (11) ◽  
pp. 935
Author(s):  
Jay S. Kaufman
Keyword(s):  
Heart Failure ◽  
African Americans ◽  
Ejection Fraction ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Reduced Ejection Fraction

scholarly journals Should Angiotensin Receptor Neprilysin Inhibitors Replace Angiotensin-converting Enzyme Inhibitors in Heart Failure With a Reduced Ejection Fraction?

2016 ◽  
Vol 2 (1) ◽  
pp. 47 ◽  
Author(s):  
Sam Hayman ◽  
John J Atherton ◽  
◽  
◽  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Reduced Ejection Fraction ◽  
Neprilysin Inhibitor

Angiotensin-converting enzyme inhibitors (ACEIs) have been the cornerstone of treatment of heart failure with reduced ejection fraction (HFrEF) for over two decades. Inhibition of neprilyisin augments vasoactive substances including natriuretic peptides, which may have multiple advantageous effects in chronic HF. Early studies of neprilyisin inhibition led to drug discontinuation due to lack of efficacy or safety concerns. Sacubitril/valsartan is a first-in-class combined angiotensin receptor/neprilysin inhibitor (ARNI). The PARADIGM-HF study demonstrated robust superiority of ARNI compared with enalapril in patients with chronic symptomatic HFrEF, raising the question of whether ACEI should still have a role in the management of HFrEF.

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