High tissue affinity angiotensin-converting enzyme inhibitors improve endothelial function and reduce infarct size

Acute effects of renin-angiotensin system blockade on arterial function in hypertensive patients

“…22 Furthermore, some data indicate that high tissue affinity ACEIs may be more beneficial in terms of outcomes in such acute conditions 18 partly because of more favourable effects on factors related to short term prognosis. 21,23,24,48 Our observations provide insights into acute pharmacological actions of different RAS blockers. However, the clinical relevance of the observed differences in acute arterial effects of RAS blockers, if any, is still speculative.…”

“…Although data with regard to a potential clinical significance of acute improvements of arterial function are lacking, there is some evidence that the acute effects of RAS blockade may be important in some clinical settings, such as acute myocardial infarction, 15,[18][19][20] coronary revascularization 19,21 and during major non-cardiac surgery. 22 Furthermore, some data indicate that high tissue affinity ACEIs may be more beneficial in terms of outcomes in such acute conditions 18 partly because of more favourable effects on factors related to short term prognosis.…”

“…17 Beyond the established benefit of long-term antihypertensive therapy, there are no data to support that acute effects of drugs -including RAS blockers -on BP and arterial function are clinically relevant in hypertensive patients. However, the acute effects of RAS blockers may be important in some other clinical settings, such as acute myocardial infarction, [18][19][20] coronary revascularization 19,21 and even non-cardiac surgery. 22 Furthermore, there is evidence that different drugs of the same class (ACEIs) may not be equally beneficial in such acute conditions.…”

“…22 Furthermore, there is evidence that different drugs of the same class (ACEIs) may not be equally beneficial in such acute conditions. 21,23,24 Data comparing the acute vascular effects of different RAS blockers in humans are limited. 16,[25][26][27] Accordingly, in the present randomized, placebo-controlled, double-blind, paralleldesign study, we investigated the acute effects of different types of RAS blockade on arterial function in a population with impaired arterial performance, using a thorough approach that evaluates endothelial function of both conductance and resistance arteries and central (aortic) haemodynamics.…”

All Coronary Artery Bypass Graft Surgery Patients Will Benefit From Angiotensin-Converting Enzyme Inhibitors

“…In a porcine model of coronary occlusion followed by cardioplegic arrest on cardiopulmonary bypass simulating CABG surgery, hearts treated with quinaprilat had significantly reduced infarct size, better recovery of regional wall motion, and better preservation of endothelial function. 13 In another series of experiments using the same porcine model of ischemia-reperfusion on cardiopulmonary bypass, animals were pretreated with quinapril (20 mg) for 7 days before surgery. 14 Quinapril-treated animals required fewer cardioversions for ventricular arrhythmias and had higher wall motion scores, more complete recovery of endothelial function, and smaller infarcts.…”