Aspirin and angiotensin-converting enzyme (ACE) inhibitors are commonly used together for treatment of ischemic heart disease in an attempt to prevent congestive heart failure. The issue of possible attenuation of the effect of ACE inhibitors by aspirin has been an area of intense debate. Currently, it is perceived that a significant part of the beneficial effect of ACE inhibitors is related to it's ability to stimulate the release of prostacyclin. Aspirin, on the other hand, inhibits the production of prostacyclin by blocking cyclooxygenase. Thus, the counteracting effect of aspirin on the augmentation of prostacyclin synthesis by ACE inhibitors could result in a potential reduction of the beneficial effects of the ACE inhibitor's and could be of great importance. The clinical implications of such an interaction are important and should be studied further.

Arch Intern Med. 2000;160:1409-1413