Angiotensin-converting enzyme (ACE) inhibitors could be helpful in patients with heart failure or left ventricular dysfunction. One study performed a review of five long-term, placebo-controlled trials in which ACE inhibitors were given to patients with heart failure, and found that the overall death rate for patients treated with ACE inhibitors was lower than that for placebo-treated patients. Patients given ACE inhibitors also required fewer hospital readdmissions for heart failure and experienced fewer heart attacks.

One downside to the use of the ACE inhibitors was that hypotension (low blood pressure) and kidney dysfunction were more common. The other study compared an ACE inhibitor to another class of medication, an angiotensin II blocker, in elderly heart failure patients. Both drugs had the same effect on heart disease, but the ACE inhibitor was better tolerated, with fewer side effects.

Lancet 2000;355:1568-1569,1575-1587