TREATMENT OF HEART-FAILURE WITH FOSINOPRIL - AN ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR WITH A DUAL AND COMPENSATORY ROUTE OF EXCRETION

Congestive heart failure (CHF) is one of the most common and clinicall y important cardiovascular diseases. This pathologic state is characte rized not only by well-defined hemodynamic alterations, but also by co mplex abnormalities involving the sympathetic nervous system, the reni n-angiotensin system, and other hormones involved in cardiovascular ho meostasis. In addition, there is an abnormality in the homeostatic car diovascular control exerted by arterial baroreceptors and the viscoela stic properties of medium-size arteries are altered, causing a reducti on in arterial compliance. All of these abnormalities can be favorably affected by angiotensin converting enzyme (ACE) inhibitors, which hav e been shown to improve not only the hemodynamic and neurohumoral prof iles of CHF, but also patient survival. CHF is accompanied with a decl ine or some sort of effect on renal function. An ACE inhibitor with a dual route of excretion, such as fosinopril, may be especially useful in treating patients with CHF. (C) 1997 American Journal of Hypertensi on, Ltd.