PREVENTION OF EVENTS WITH ANGIOTENSIN CONVERTING ENZYME INHIBITORS

一项临床试验，以确定用于治疗高血压和心力衰竭的药物群多普利是否也可以预防冠心病（CHD）患者的心脏病发作和死亡。冠心病仍然是美国的一个主要健康问题。通过及时使用阿司匹林、β受体阻滞剂和恢复血液流向心脏受影响区域的方案，在急性梗死患者的管理方面取得了重大进展，这导致住院死亡率大幅下降。已经经历过心肌梗死（由于缺乏流向该区域的血液而导致心脏组织死亡）的患者继续获得现代治疗的益处，并更加关注已知风险因素的改变。一些危险因素的治疗方法是降低血压和胆固醇，戒烟和改变生活方式。此外，ACE抑制剂治疗（血管紧张素转换酶[一种引起血管扩张和平滑肌收缩的激素]）已被证明对全身性高血压患者和充血性心力衰竭患者具有价值，这是一个强有力但未经证实的理由。本研究的主要目的是测试是否加入ACE抑制剂群多普利将降低心血管性心脏病患者的心血管死亡或非致命性心肌梗死的发生率，但保留左心室功能。本研究的受试者将是50岁及以上的男性和女性，患有CHD，他们的心脏泵血能力必须正常至接近正常。受试者不能有肾功能异常、高血压、高血钾或怀孕。入组研究时，将测量身高、体重和血压。将采集血液和尿液样本以测量风险因素。将讨论健康和药物，并提供群多普利。如果药物没有问题，患者将被随机分配接受群多普利或安慰剂。在研究期间，将每6个月对CRC进行一次回访，以更新记录和新的药物供应。

A clinical trial to determine if trandolapril, a drug used to treat high blood pressure and heart failure, can also prevent heart attacks and death in patients with coronary heart disease (CHD). Coronary heart disease remains a major health problem in the United States. Major strides have been made in the management of acute infarct patients with the prompt use of aspirin, beta blockers, and regimens to restore the flow of blood to an effected area of the heart, which have resulted in major reductions in in-hospital deaths. Patients who have already experienced a myocardial infarction (the death of tissue in the heart due to the lack of blood flow to that area), continue to receive benefits of contemporary therapies and greater attention directed towards modification of the known risk factors. Some treatments of risk factors are the lowering of blood pressure and cholesterol, stoppage of smoking, and changing life style. In addition, there is strong, yet unproven rationale, that ACE inhibitor therapy (angiotensin converting enzyme [a form of hormone that causes the dilation of blood vessels and the contraction of smooth muscles]) are of proven value for patients with systemic high blood pressure and for therapy for congestive heart failure. The primary goal of this study is to test whether the addition of the ACE inhibitor trandolapril will reduce the incidence of cardiovascular death or non-fatal myocardial infarction in patients with cardiovascular heart disease, but with preserved left ventrical function. The subjects of this study will be men and women 50 years and older, with CHD and the ability of their hearts to pump blood must be normal to nearly normal. Subjects cannot have abnormal kidney function, high blood pressure, high blood potassium, or be pregnant. At entry to the study, height, weight, and blood pressure will be measured. Samples of blood and urine will be collected to measure risk factors. Health and medications will be discussed and a supply of trandolapril will be given. If there is no problem with the medication, patients will then be randomly assigned to receive either trandolapril or a placebo. Return visits to the CRC will be every six months for the duration of the study for updates of records and a new supply of the medication.