ACE Inhibitors

by Pedro D'Orléans-Juste (Editor), G.E. Plante (Editor)

Overview

Angiotensin converting enzyme inhibitors (ACEI) represent the first class of antihypertensive agents that was designed and developed on the basis of a well-defined physiopathological axis of arterial hypertension, a vascular dis­ order that is now becoming one of the major causes of morbidity/mortality, not only in developed societies but also in the highly populated developing coun­ tries [1]. CAPTOPRIL, the prototype of the "PRIL" family, which now comprises more than 40 molecule-species, was quite hazardous and the clinical develop­ ment almost failed when serious side-effects were reported in an alarmist fash­ ion in reputable scientific journals, such as the New England Journal of Medicine and Lancet. Squibb&Sons came very close to withdrawing CAPTOPRIL from clinical investigation [2]. However, after re-examination of the data obtained from different categories of patients and appropriate dose-adjustments, the clinical use of CAPTOPRIL turned out to be revolutionary. The prototype, as well as other members of the "PRIL" family became the starting point for numerous basic and clinical research programs, focusing on the interactions of ACEI with the kinin, endothelin, and nitric oxide systems, and the contribution of the receptors for AT I, AT 2, bradykinin Bland B , ETA and ET B to the pharmacological actions 2 of the respective peptides. This research activity led to the development of new pharmacological agents, such as the angiotensin receptor antagonists and, more recently, the neutral endopeptidase inhibitors. In the near future, bradykinin receptor antagonists also will be available to modulate ACEI phar­ macological actions.

Product Details

ISBN-13:	9783034875790
Publisher:	Birkhäuser
Publication date:	12/06/2012
Series:	Milestones in Drug Therapy
Sold by:	Barnes & Noble
Format:	eBook
File size:	6 MB

About the Author

D'Orléans-Juste, Pedro; Plante, Gérard E.

Table of Contents

The history of inhibitors of angiotensin converting enzyme.- Genetics of the renin-angiotensin-aldosterone system and risk of arterial disease.- Crosstalk between ACE inhibitors, B2 kinin receptor and nitric oxide in endothelial cells.- Interactions between the ACE and the endothelin pathway.- Evaluative and epidemiological approaches of ACE therapy.- The role of ACE inhibition in heart failure.- Angiotensin converting enzyme inhibition in the microcirculation.- Arterial structure and function and blockade of the reninangiotensin system in hypertension.- The contribution of angiotensin-converting enzyme (ACE) to the metabolism of kinins (bradykinin and des-Arg9-bradykinin) and effect of ACE inhibitors on their in vitro and in vivo metabolism.- Role of the renin-angiotensin system on the central and peripheral autonomic nervous system.- Dual inhibitors of angiotensin converting enzyme and neutral endopeptidase.- Pharmacodynamics, tissue-specificity of ACE inhibitors.- Effect of angiotensin converting enzyme inhibition on thirst and salt-appetite.- ACE and diabetes.

Editorial Reviews

3 Stars from Doody

Reviewer: Irving H Zucker, Ph.D.(University of Nebraska Medical Center)
Description: This book reviews the basic science background and clinical rationale for the use of angiotensin converting enzyme (ACE) inhibitors in the treatment of hypertension and heart failure. The chapters are organized into background material, cellular and molecular mechanisms of action, and the efficacy of using these agents in a clinical setting.
Purpose: The pupose is to bring the reader up to current thinking concerning the use of and the rationale for ACE inhibitor therapy. These objectives are necessary and the book does an adequate job of summarizing pertinent issues relating to ACE inhibition.
Audience: This book is written for the clinician or basic scientist who wishes to obtain a relatively rapid review of ACE inhibitors. In my judgment, it is not written for the investigator who wants a comprehensive review of the field. The chapters are short and do not completely review each field. The editors have done a fine job of putting together what amounts to a "primer" on ACE inhibition.
Features: This book covers the history of and the basic science behind the development of ACE inhbitors and the clinical trials which solidified their use in vascular disease management. The basic science chapters are, in general, better and more comprehensive than the clinical sections. There are many excellent figures depicting the mechanisms of action of ACE inhibitors in various organ systems.
Assessment: This is a good review of the area of ACE inhibition. It provides a rapid and, by and large, well written summary of pertinent areas of both the basic science and clincial aspects of ACE inhibition. One drawback is the relatively brief overview of most of the chapters. This book would not be suitable as a resource reference for a comprehensive and well annotated book on ACE inihibtors. There are many pertinent experiments and studies which could have been cited to make this a more relevant contribution to the field. In spite of this concern, this is a worthwhile book for those interested in this field.

Doody's Review Service