So what should patients do in the meantime?
It is far too early to start advocating ACE inhibitors for all elderly patients. Switching patients to centrally acting ACE inhibitors is a difficult and an expensive undertaking and should only be done on a case-by-case basis. The director of the above study, Dr Sink, recommends that, “if the patient does not have a contraindication for an ACE inhibitor, then switching to a centrally active ACE inhibitor is a reasonable choice. In addition, for those already on ACE inhibitors, our study results would support the use of a centrally active ACE inhibitor over a non–centrally active one,"
Centrally active ACE inhibitors included captopril (Capoten, Bristol-Myers Squibb), fosinopril (Monopril, Bristol-Myers Squibb), lisinopril, perindopril, ramipril (Altace, King Pharmaceuticals), and trandolapril (Mavik, Abbott Laboratories). Non–centrally active ACE inhibitors included benazepril (Lotensin, Novartis Pharmaceuticals), enalapril (Vasotec, Merck), moexipril (Univasc, Schwarz Pharma), and quinapril (Accupril, Pfizer).
The study is published in the July 13 issue of Archives of Internal Medicine.