ACE inhibitors reduce morbidity and mortality in patients with heart fillure and are considered first-line treatments. However, hypotention, with potentialy significant consequentces, may occur in some patients following their first dose. Studies haves suggested that not all ACE inhibitors induce first dose hypotention and that some may be more suitable to initiate therapy than others.
In the clinical setting we conclude that a qualitative difference exists between the different ACE inhibitors with respect to first dose hypotention in patients with heart failure. Perindopril has shown less reduction in blood pressure, with a lower number of symtomatic or asymtomatic hypotensive episodes and therefore appears to be amore suitable ACE inhibittors for the initiation of heart fillure treatment than the other agents tasted.
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