Angiotensin-converting enzyme inhibitors contraindications

To control risk factors and prevent major adverse cardiac events, statin therapy should be considered in all patients with ischemic heart disease, particularly in those with elevated low-density lipoprotein cholesterol. In the absence of contraindications, angiotensin-converting enzyme inhibitors should be considered in ischemic heart disease patients who also have diabetes melli-tus, left ventricular dysfunction, history of myocardial infarction, or any combination of these. Angiotensin receptor blockers... 

The angiotensin-converting enzyme (ACE) inhibitors are recommended when the preferred first-line agents (diuretics or (S-blockers) are contraindicated or ineffective. Despite their wide-spread use, it is not clear if antihypertensive therapy with ACE inhibitors increases the risk of other major diseases. 

The current national guidelines recommend that all patients be given the following unless contraindications exist (1) aspirin, (2) /S-blockers with prior MI, (3) angiotensin-converting enzyme (ACE) inhibitor to patients with CAD and diabetes or LV systolic dysfunction, (4) LDL-lowering therapy with CAD and an LDL concentration... 

Following Ml, all patients, in the absence of contraindications, should receive indefinite therapy with aspirin, a 8-blocker and an angiotensin-converting enzyme (ACE) inhibitor for secondary prevention of death, stroke, and recurrent infarction. Most patients will receive a statin to reduce low-density lipoprotein cholesterol to less than 70 to 100 mg/dL. Anticoagulation with warfarin should be considered for patients at high risk of death, reinfarction, or stroke. 

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