Angiotensin-Converting Enzyme Inhibitors and Diuretics: Optimal Combination Therapy

Abstract

Letters7 December 2004Angiotensin-Converting Enzyme Inhibitors and Diuretics: Optimal Combination TherapyBarry R. Davis, MD, PhD, Curt D. Furberg, MD, PhD, Jackson T. Wright Jr., MD, PhD, Jeffrey A. Cutler, MD, MPH, and Paul Whelton, MD, MScBarry R. Davis, MD, PhDFrom The University of Texas School of Public Health at Houston, Houston, TX 77030; Wake Forest University School of Medicine, Winston-Salem, NC 27157; Case Western Reserve University, Cleveland, OH 44106; National Heart, Lung, and Blood Institute, Bethesda, MD 20892; and Tulane University Health Sciences Center, New Orleans, LA 70112.Search for more papers by this author, Curt D. Furberg, MD, PhDFrom The University of Texas School of Public Health at Houston, Houston, TX 77030; Wake Forest University School of Medicine, Winston-Salem, NC 27157; Case Western Reserve University, Cleveland, OH 44106; National Heart, Lung, and Blood Institute, Bethesda, MD 20892; and Tulane University Health Sciences Center, New Orleans, LA 70112.Search for more papers by this author, Jackson T. Wright Jr., MD, PhDFrom The University of Texas School of Public Health at Houston, Houston, TX 77030; Wake Forest University School of Medicine, Winston-Salem, NC 27157; Case Western Reserve University, Cleveland, OH 44106; National Heart, Lung, and Blood Institute, Bethesda, MD 20892; and Tulane University Health Sciences Center, New Orleans, LA 70112.Search for more papers by this author, Jeffrey A. Cutler, MD, MPHFrom The University of Texas School of Public Health at Houston, Houston, TX 77030; Wake Forest University School of Medicine, Winston-Salem, NC 27157; Case Western Reserve University, Cleveland, OH 44106; National Heart, Lung, and Blood Institute, Bethesda, MD 20892; and Tulane University Health Sciences Center, New Orleans, LA 70112.Search for more papers by this author, and Paul Whelton, MD, MScFrom The University of Texas School of Public Health at Houston, Houston, TX 77030; Wake Forest University School of Medicine, Winston-Salem, NC 27157; Case Western Reserve University, Cleveland, OH 44106; National Heart, Lung, and Blood Institute, Bethesda, MD 20892; and Tulane University Health Sciences Center, New Orleans, LA 70112.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-11-200412070-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Krantz for his thoughtful letter. The proposed strategy of using a diuretic and an ACE inhibitor simultaneously is supported by the effects of combined treatment in the Perindopril Protection Against Recurrent Stroke Study (PROGRESS) (1). However, that study could also be (and was) interpreted as showing that it's the blood pressure that matters, especially for stroke, and blood pressure reduction is much more effective with a diuretic in the regimen. Although the use of ACE inhibitors could in theory offset the metabolic effects (higher glucose and lower potassium levels) of thiazides, other potassium-sparing regimens may ...Reference1. Chapman N, Huxley R, Anderson C, Bousser MG, Chalmers J, Colman S, et al. Effects of a perindopril-based blood pressure-lowering regimen on the risk of recurrent stroke according to stroke subtype and medical history: the PROGRESS Trial. Stroke. 2004;35:116-21. [PMID: 14671247] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The University of Texas School of Public Health at Houston, Houston, TX 77030; Wake Forest University School of Medicine, Winston-Salem, NC 27157; Case Western Reserve University, Cleveland, OH 44106; National Heart, Lung, and Blood Institute, Bethesda, MD 20892; and Tulane University Health Sciences Center, New Orleans, LA 70112. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoALLHAT: Setting the Record Straight Barry R. Davis , Curt D. Furberg , Jackson T. Wright Jr. , Jeffrey A. Cutler , Paul Whelton , and Angiotensin-Converting Enzyme Inhibitors and Diuretics: Optimal Combination Therapy Mori J. Krantz and Philip S. Mehler Metrics 7 December 2004Volume 141, Issue 11Page: 893KeywordsACE inhibitorsBlood pressureDiureticsDrugsEnzyme replacement therapyGlucoseHeart failurePotassiumRandomized trialsStroke ePublished: 7 December 2004 Issue Published: 7 December 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...