Angiotensin Converting Enzyme (Ace) Inhibitor 2

Question

Vignette: A 45-year-old man with a history of hypertension and diabetes is brought to the emergency department with severe chest pain radiating to his left arm. His blood pressure is 165/95 mmHg and pulse is 88/min. The ECG shows ST-segment elevation in leads II, III, and aVF. He is diagnosed with inferior wall myocardial infarction. He is started on aspirin, clopidogrel, and nitroglycerin. A medication is planned to be added to reduce his mortality risk. This medication works by blocking the conversion of angiotensin I to angiotensin II. Which of the following medications is most likely planned to be added?

Choices

A. Lisinopril

B. Metoprolol

C. Furosemide

D. Amlodipine

E. Hydralazine

Answer

A. Lisinopril

Explanation

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor, which works by blocking the conversion of angiotensin I to angiotensin II, thereby reducing the levels of angiotensin II. Angiotensin II is a potent vasoconstrictor and also stimulates the release of aldosterone, leading to sodium and water retention. By reducing the levels of angiotensin II, ACE inhibitors help in lowering the blood pressure and reducing the workload on the heart, which is particularly beneficial in patients with myocardial infarction. ACE inhibitors have been shown to reduce mortality in patients with acute myocardial infarction, and hence, are considered a standard part of therapy.