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ACE inhibitors or ARB drugs

ACE INHIBITOR

All patients should be offered an ACE inhibitor (or, if not tolerated, an A2 antagonist) unless contraindicated (e.g. renal disease, creatinine >220micromol/l).

ACE inhibitors are used to lower mortality in addition to any use for BP reduction.

Ramipril 2.5 mg daily is the recommended drug and starting dose. Dose should be titrated to maximum tolerated dose.

Click here for information on pharmacological management of CHD.

A2 ANTAGONIST

Only use for secondary prevention of CVD if ACEi not tolerated or contraindicated.

Losartan is drug of first choice for secondary prevention.

If LVSD - see here for guideline: