caa a22 4500 477072399 CHVBK 20180405111430.0 cr unu---uuuuu 170330e19960901xx s 000 0 eng 10.1007/BF00051113 doi (NATIONALLICENCE)springer-10.1007/BF00051113 Pitt Bertram University of Michigan School of Medicine, Ann Arbor, MI, USA aut Effect of ACE inhibitors on endothelial dysfunction: Unanswered questions and implications for further investigation and therapy [Elektronische Daten] [Bertram Pitt] Summary: Experimental studies have suggested that angiotensin-converting enzyme (ACE) inhibitors may have an important role in blocking the progression of and/or reversing endothelial dysfunction. The extrapolation of these experimental studies to the clinical situation has, however, been disappointing. Studies of forearm-mediated endothelial vasodilatation in patients with hypertension with captopril, enalapril, and cilazapril have been negative. The finding of the Trial in Reversing Endothelial Dysfunction (TREND) that the administration of quinapril to normotensive patients with coronary artery disease in part restores endothelial-mediated coronary vasodilation, as assessed by intracoronary administration of acetylcholine, has important implications for future therapy and raises several important questions. The differences in the TREND and previous studies of ACE inhibitors on endothelial dysfunction may be due to mechanistic differences in endothelial dysfunction in patients with coronary artery disease and hypertension. Although in general there has been a good correlation between endothelial dysfunction as assessed by forearm flow and coronary endothelial dysfunction as assessed by acetylcholine, these vascular beds may be affected differently by therapeutic interventions, especially with an ACE inhibitor, which may affect sheart stress and angiotensin II formation in different vascular beds differently. Third, one needs to question whether the effect of quinapril on coronary endothelial dysfunction is a class effect or unique to quinapril. It will be necessary to test the effectiveness of other ACE inhibitors on coronary endothelial dysfunction in humans before concluding that the beneficial effects of quinapril are due to a class effect. Kluwer Academic Publishers, 1996 endothelial dysfunction nationallicence ACE inhibitors nationallicence hypertension nationallicence coronary artery disease nationallicence Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/4(1996-09-01), 469-473 0920-3206 10:4<469 1996 10 10557 https://doi.org/10.1007/BF00051113 text/html Onlinezugriff via DOI 1 editorial jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00051113 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Pitt Bertram University of Michigan School of Medicine, Ann Arbor, MI, USA aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/4(1996-09-01), 469-473 0920-3206 10:4<469 1996 10 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer