CARDIOLOGY: Study Supports Higher ACE Inhibitor Dosage
A recent study has found that "[d]octors could avoid 250,000 hospital admissions in the United States each year by sharply increasing doses of" ACE inhibitors, which are "used to treat congestive heart failure." The AP/Los Angeles Times reports that a five-year, 19-country study observed 3,164 patients taking lisinopril, or zestril, an ACE inhibitor made by Zeneca Pharmaceuticals, which sponsored the study. Comparing patients who took high versus low doses, study director Dr. Milton Packer of Columbia University concluded that "the low dose is not nearly as effective and the side effects are similar" (Haney, 3/31). The study found that patients on doses of lisinopril "more than four times greater than that usually prescribed by physicians" reduced their risk of dying from chronic heart failure by 8%. "Patients who received high doses lived longer and were hospitalized less than those who received low doses," according to the study (Reuters/New York Times, 3/31). The AP/Los Angeles Times notes that many doctors typically prescribe small doses because "the drugs sometimes cause kidney problems and dangerously low blood pressure" (3/31).
USA Today reports that "inadequate doses" of the ACE inhibitors "costs both lives and money, raising the risk of heart disease death 10%." In the U.S. alone, "[u]sing the right dose could save $2 billion a year," the study concludes. In presenting his findings to the American College of Cardiology, Packer noted that many doctors "assumed that the high-dose and low-dose regimens were equally effective." He said, "We are asking physicians to take a drug we know works and use it the right way," (Sternberg, 3/31). Study coauthor Dr. John Cleland of the University of Glasgow noted that increased dosages would result in fewer hospitalizations, which "would average out to a savings of $350 per patient per year." The AP/Los Angeles Times reports that "[r]esearchers said they hope their findings will result in an immediate change in the way doctors prescribe" ACE inhibitors (3/31).