Gustafsson F, Torp-Pedersen C, Kober L, Hildebrandt for the TRACE Study Group
A history of arterial hypertension increases benefit of ACE inhibition after acute myocardial infarction
12th Annual ASH Meeting
Am J Hypertens (Apr) 10:79A 1997

Infarct expansion may pose a greater risk for hypertensives, and this may be attenuated with ACE inhibitors. Therefore, this group evaluates the effect of ACE inhibitors in a selected group of hypertensive patients with LV systolic dysfunction and an ejection fraction below 35 %. The study is a retrospective analysis of the "Trace" study, from Denmark.

Analysis of data from 1749 patients with AMI and decreased LV function showed a marked reduction in the relative risk of death (RR) from any cause in the hypertensive group (0.59, p < 0008). On the other hand, the reduction was not significant for normotensives.

Comment: This paper convincingly shows that ACE inhibitors result in a significant decrease in the RR for death after an AMI in hypertensives with a reduced LV systolic function. (Armando Lindner, M.D., University of Washington, Seattle)

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12th Annual ASH Meeting
H: Drug therapy : ACE inhibitors
H: Pathophysiology : Heart in hypertension