The antianginal activity of drugs in this group is slightly lower than that of calcium antagonists. In some cases, there is evidence of the occurrence of myocardial ischemia by the mechanism of “stealing”. At the same time, long-term use of ACE inhibitors in patients after myocardial infarction, allows to delay the re-development of myocardial infarction.
The first generation ACE inhibitors include Capoten , the active substance of which is captopril. The usual daily dose is 50 mg, it is designed for one or two doses. Another drug of this group, Ramipril He was well-established in clinical trials at the Research Institute of Cardiology named after him in patients with diabetes mellitus and arterial hypertension, especially with the prevalence of clinical disorders of hemodynamics and microcirculation in peripheral tissues. Ramipril was shown to have a more pronounced vasodilating effect on small and medium-sized arteries, arterioles and the capillary network. An important positive feature of Ramipril is the possibility of achieving a good therapeutic effect with the use of small doses of the drug, from 1.0 to 5.0 mg per day. Renitec (enalapril maleate) is a prolonged form of an ACE inhibitor. According to clinical studies, it is indicated for patients with diabetes mellitus and ischemic heart disease, increases cardiac output, renal blood flow, has a nephroprotective effect, has a beneficial effect on the plasma spectrum of lipoproteins. Its therapeutic dose is 5 to 40 mg once daily.
The drugs of the new generation of ACE inhibitors include Prestarium . There are experimental data indicating a decrease in hypertrophy of smooth muscle cells, an improvement in the elastin-collagen ratio, and an improvement in the signs of incipient nephropathy. Proved the benefit of a curious effect on the coronary reserve. The therapeutic dose of the drug is 4-8 mg per day.
The disadvantages of ACE inhibitors is their high cost.