EFFECTS OF ANTIHYPERTENSIVE AGENTS ON CORONARY-ARTERY DISEASE RISK-FACTORS

The adverse effects of certain antihypertensive medications, most nota bly diuretics and beta blockers, on serum lipids, glucose, and potassi um may explain why control of hypertension has not been accompanied by declines in coronary artery disease. Evidence indicates that angioten sin-converting enzyme (ACE) inhibitors, including quinapril, the newes t member of this class of drugs, have no deleterious effects on these coronary risk factors. In addition to differences in chemical structur e, the unique activity of quinapril at the local tissue level might to some degree explain its comparatively favorable clinical profile. Con sequently, ACE inhibiting agents may be better choices for the managem ent of patients with mild-to-moderately elevated blood pressure. Howev er, controlled clinical trials with these drugs are needed to determin e their impact on events related to coronary artery disease.