ACE inhibitors in a multimorbid patient: focus on fosinopril

Changes in the profile of risk factors, the neglect of simple preventive measures and the use of low doses of medication lead to the appearance of numerous multimorbid patients. Each practitioner faces this issue, both at the start of drug selection and during treatment. The more difficult a patient is, the more difficult it is to select medications of choice. This translates into polypharmacy and reduced therapeutic effectiveness. The basic rule of multimorbid patient treatment is the use of the most studied, safe and strategically efficient agents to improve hemodynamic parameters and quality of life. Meanwhile, the most important goal (sometimes overlooked) is to improve the prognosis at each stage of multimorbidity. ACE inhibitors in optimal dosages with a maximum safety profile are preferred drugs in multimorbid patients. According to the U.S. Ambulatory Guidelines (2019) and KDIGO 2021, of the ACE inhibitors used in daily practice, fosinopril is the safest medication in multimorbid patients. KEYWORDS: ACE inhibitors, fosinopril, multimorbid patients, treatment, congestive heart failure. FOR CITATION: Fomin I.V. ACE inhibitors in a multimorbid patient: focus on fosinopril. Russian Medical Inquiry. 2022;6(1):12–20 (in Russ.). DOI: 10.32364/2587-6821-2022-6-1-12-20