Best drug for Angina with hypeension is?
High-Yield Explanation
Ref Davidsons Principles and practice of medicine_22Ed page no 551 Angiotensin-conveing enzyme inhibition therapy Angiotensin-conveing enzyme (ACE) inhibition therapy interrupts the vicious circle of neurohumoral activation that is characteristic of moderate and severe hea failure by preventing the conversion of angiotensin I to angiotensin II, thereby preventing peripheral vasoconstriction, activation of the sympathetic nervous system , and salt and water retention due to aldosterone release. These drugs also prevent the undesirable activation of the renin-angiotensin system caused by diuretic therapy. In moderate and severe hea failure, ACE inhibitors can produce a substantial improvement in effo tolerance and in moality. They can also improve outcome and prevent the onset of ove hea failure in patients with poor residual left ventricular function following MI ACE inhibitors can cause symptomatic hypotension and impairment of renal function, especially in patients with bilateral renal aery stenosis or those with preexisting renal disease. An increase in serum potassium concentration may occur that can offset hypokalaemia associated with loop diuretic therapy. Sho-acting ACE inhibitors can cause marked falls in BP, paicularly in the elderly or when staed in the presence of hypotension, hypovolaemia or hyponatraemia. In stable patients without hypotension (systolic BP over 100 mmHg), ACE inhibitors can usually be safely staed in the community. However, in other patients, it is usually advisable to withhold diuretics for 24 hours before staing treatment with a small dose of a long-acting agent, preferably given at night Renal function and serum potassium must be monitored and should be checked 1-2 weeks after staing therapy. <img alt="" src=" />