All of the following are the indications for use of ACE inhibitors, except'.
Ans. is 'd' i.e., Pheochromocytoma Uses of ACE inhibitorHypertension -The antihypertensive effect of ACE inhibitor results primarily from vasodilationACE inhibitors are now the first line drugs in all grades of hypertension (About 50% of patients respond to monotherapy)ACE inhibitors are most useful in hypertension when the raised blood pressure results from excess renin production (renovascular hypertension)Cardiac failure -Multicentric trials have shown that ACE inhibitors retard the progression of left ventricular systolic dysfunction and prolong survival of CHF patients of all grades (I to TV) (they reduce mortality).Unless contraindicated ACE inhibitors are now advocated as first line drugs in all patients with symptomatic as well as asymptomatic left ventricular inadequacy.Diabetic nephropathy -Prolonged ACE inhibitor therapy has been found to prevent or delay end stage renal disease in type 1 as well as type II diabetics.ACE inhibitors are the first line drug for hypertensive type 1 diabetics. There is also evidence that ACE inhibitors have a proteinuria-sparing effect in type I diabetics with normal B.P.All patients with diabetic nephropathy, whether hypertensive or normotensive deserve ACE inhibitor therapy.Myocardial infarction -ACE inhibitors given after M.I. markedly reduces the incidence of heart failure.Scleroderma crisis -Ace inhibitors cause dramatic improvement in patients of scleroderma crisis with marked rise in B.P. and deterioration in renal function.Prophylaxis in high cardiovascular risk subjectsACE inhibitors tilt the fibrinolytic balance towards a profibrinolytic state by reducing plasma levels of plasminogen activator inhibitor -1.
Hypertension
Myocardial Infarction
Left Ventricular Dysfunction
Pheochromocytoma
ACE Inhibitors