Which ACE inhibitor should be used for secondary stroke prevention?

A.V. Savustyanenko


During last decades it was developed more than 10 ACE inhibitors and was largely extended the spectrum of its clinical use. As result it is interesting to answer the question which drug is more suitable for treatment of each certain disease. Ramipril is one of the first choice drugs between ACE inhibitors which possible use for secondary stroke prevention. Current data suggest that this clinical effect is only partially associated with antihypertensive activity of drug. Additional factors include its ability to decrease the progress of atherosclerosis, anti-inflammatory effects (probably), positive effects on glucose metabolism, antiaggregant and anticoagulant properties and the absence of negative effects onto the brain blood flow. Use of ramipril for secondary stroke prevention decreases direct health care costs. Anti-stroke effects of ramipril can be enforced by combined treatment with thiazide diuretic (e.g. indapamide).


stroke; secondary prevention; ACE inhibitors; ramipril


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