Health

New Mantra For Cardiologists Everywhere

For quite some time, cardiologists and internal medicine specialists have known that the ACE is bad news. We don't know what impact this has had on those of the medical fraternity who love to play a game of cards during weekends. Perhaps some day, a young research worker will do a controlled trial on this and earn a PhD in the process. 

But for the last several years, the ACE (an enzyme responsible for raising one's blood pressure and a whole lot of other nasty things) has been a prime target of physicians dealing with high blood pressure and even an early case of kidney failure. So it gave birth to a whole generation of medicines known as ACE inhibitors, which quickly caught the fancy of heart specialists everywhere. 

Now it turns out that medicines which block the ACE can achieve a lot more: they can save people from dying because of heart attacks, stave off an oncoming paralytic stroke in many cases and postpone the complications of diabetes. Quite a basketful, that! But when a prestigious medical publication like the New England Journal of Medicine (NEJM) says that, most of our doctors have no choice except to believe it. 

In fact, the latest article in the NEJM, which focuses on one such medicine, Ramipril, claims that the drug can do better than save people from death. The article talks about just one aspect of a gigantic research project, known as the Heart Outcomes Prevention Evaluation (HOPE) study, in which the condition of over 9,200 patients was examined over a period of about two years.

The conclusions: "Ramipril significantly reduces the rates of death, myocardial infarction (a heart attack, in plain English), and (paralytic) stroke in a broad range of high-risk patients, who are not known to be suffering from heart failure." A later part of the same article points out that among those who were given Ramipril, fewer people needed a bypass surgery, and when they required hospitalization for heart problems, it was for a shorter duration than before.

This could mean different things for different people. Someone who has high blood pressure would get some relative protection from a heart attack, another person who might have had to put with drowsiness because of strong blood pressure drugs could now switch to a lower dose. Yet another who would have to live in constant fear of a blood clot in the brain, can now rest a little easier… the stroke when it comes would perhaps be milder than otherwise. 

17-Aug-2000

More by :  Dr. Sumit Ghoshal

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