Are ACE inhibitors better than ARBs?

This month, in the diabetes section of Cardiology Review, Dr. Gerald S. Werner from Germany reports on a study of 90 patients (30 with diabetes) that correlated the significance of coronary collateral recruitment in detecting future adverse cardiac events. Diabetic patients fared worse, as Dr. Richard E. Stewart explains in his commentary.

In the heart failure section, Drs. Kenneth Dickstein and John Kjekshus from Norway studied the effects of losartan (an angiotensin receptor blocker [ARB]) and captopril (an angiotensin-converting enzyme [ACE] inhibitor) on morbidity and mortality in high-risk patients with left ventricular dysfunction after acute myocardial infarctions. In his commentary, Dr. Alan G. Wasserman emphasizes the usefulness of ARBs in this setting, though ACE inhibitors are still the first-line drugs of choice.

In the hypertension section, Drs. Markus P. Schlaich and Elisabeth Lambert, from Australia, evaluated cardiac sympathetic activity in 26 hypertensive patients and 10 controls and found that an increase in such activity contributes to the development of hypertensive left ventricular hypertrophy. Dr. Samuel J. Mann comments on their findings.

In the coronary artery disease and angina section, Dr. Zoran Olivari and colleagues from Italy report the immediate results and 1-year clinical follow-up after percutaneous coronary interventions in 419 patients enrolled in a multicenter study. Their successful results are commented on by Dr. Richard J. Katz.

Be sure to look for our special issue next month on Cardiovascular Disease in the Elderly. It will include articles on erectile dysfunction and polypharmacy.