Key result
Fosinopril provides effective blood pressure control and organ protection with a high safety profile across the cardiovascular continuum due to its high lipophilicity and dual elimination route.
Why the study?
Physicians frequently group ACE inhibitors by class effect rather than specific pharmacokinetics, pharmacodynamics, and organ protection, leading to suboptimal drug selection across the cardiovascular continuum.
Does fosinopril provide effective organ protection and clinical benefits across different stages of the cardiovascular continuum?
Does fosinopril provide effective organ protection and clinical benefits across different stages of the cardiovascular continuum?
Fosinopril is a highly lipophilic ACE inhibitor with dual elimination pathways, offering effective organ protection and safety across the cardiovascular continuum, particularly in patients with renal impairment.
May support fosinopril consideration in renal impairment; leaves open randomized confirmation across the cardiovascular continuum.
In daily clinical settings, drug choice most commonly ends in two variants: physician lefts unchanged previously prescribed therapy and does not titer dosages, or recommends less expensive medication instead. A myriad of brand-name and generic cardiologic medicines has led to the fact that physicians group drugs by their class effect but forget that any drug is characterized by specific pharmacokinetics, pharmacodynamics, and effects on target organs. Grouping by class effect results in an unreasonable change to less effective medication. The diversity of pharmacokinetics, pharmacodynamics, and organ protection is particularly clear in a group of angiotensin-converting enzyme (ACE) inhibitors. This paper describes in detail the characteristics and clinical effects of ACE inhibitors. Pharmacological properties and clinical characteristics of fosinopril are emphasized. This paper also addresses clinical studies on ACE inhibitors which allow for rational drug choice at any stage of the cardiovascular continuum. KEYWORDS: ACE inhibitors, hypertension, proteinuria, atherosclerosis, diabetes. FOR CITATION: Fomin I.V., Vinogradova N.G. Angiotensin-converting enzyme inhibitors at the stages of the cardiovascular continuum: missed opportunities and real prospects. Russian Medical Inquiry. 2021;5(4):225–231 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-225-231.
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Fomin et al. (2021) conducted a review in Cardiovascular diseases (hypertension, heart failure, chronic kidney disease). Fosinopril vs. Other antihypertensive drugs or placebo was evaluated. Fosinopril provides effective blood pressure control and organ protection with a high safety profile across the cardiovascular continuum due to its high lipophilicity and dual elimination route.
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