Last Updated: 2003-09-01 10:04:12 -0400 (Reuters Health)

VIENNA (Reuters) - All coronary disease patients should be considered for treatment with an ACE inhibitor, a blood pressure medicine that would stop hundreds of thousands of deaths from the condition, researchers said Sunday.

Coronary artery disease -- in which the blood vessels supplying the heart become narrowed -- is the most common cause of heart disease, the biggest killer in the Western world.

Currently, such patients are typically given aspirin and cholesterol-lowering statin drugs.

But Professor Kim Fox of the Royal Brompton Hospital in London told the annual meeting of the European Society of Cardiology that new clinical trial data showed the clear benefits of adding an ACE inhibitor to this therapy regimen.

The so-called Europa study found patients given the ACE inhibitor perindopril, in addition to standard treatment, had a 20 percent lower risk of cardiovascular death, heart attack and cardiac arrest.

"We are going to make a major recommendation here. We are asking the government authorities to consider giving perindopril to all people with coronary disease," Fox told reporters.

Perindopril, one of a number of rival drugs with the same mode of action, is sold under the brand Coversyl by privately owned French firm Servier, which funded the four-year study involving more than 12,000 patients -- the largest of its kind.

MILESTONE

Fox, who co-chaired the study, said the results were a "milestone in cardiology," proving for the first time the life-saving benefits of an ACE inhibitor in a broad range of patients.

In a country the size of Britain, with a population of 60 million, adding perindopril to standard therapy would stop 100,000 heart attacks or cardiovascular deaths over a four-year period, he added.

"I think governments will respond in the same way they did with statins" which are now widely used as a preventative treatment, he added.

Previous research, published four years ago, had shown the benefits of another ACE inhibitor, Aventis SA's ramipril or Altace, in coronary disease patients over 55 years old with high-risk conditions such as diabetes.

But this is the first time the benefits of the drug class have been proven across all patients with the disease. Many of those enrolled in the Europa study had no symptoms.

Professor Maarten Simoons of the Thoraxcenter Erasmus Medical Center in Rotterdam said it was too early to assess cost-effectiveness, but he noted ACE inhibitors were typically half the price of statins. Statin drugs, such as Pfizer Inc.'s Lipitor, cost around 600 euros per patient a year in the Netherlands.

ACE inhibitors work by inhibiting angiotension converting enzyme, which plays a crucial role in the production and breakdown of various chemicals involved in blood pressure regulation.

In addition, however, they can also improve heart and blood vessel wall structure and function, preventing vessel constriction and suppressing unnecessary blood clotting.