Angiotensin-converting enzyme inhibitors, angiotensin II receptors antagonists, beta-blockers and ivabradine as supportive therapy in pulmonary hypertension: Drug safety and tolerability

Published: 9 July 2017
Author(s): Michele Correale, Stefano Zicchino, Ilenia Monaco, Matteo Di Biase, Natale Daniele Brunetti
Issue: July 2017
Section: Letter to the Editor

According to the 2015 ESC guidelines for diagnosis and treatment of pulmonary hypertension (PH), the use of angiotensin-converting enzyme inhibitors (ACEi), angiotensin-II receptor blockers (ARBs), beta-blockers (BBs) and ivabradine (Iva) is not recommended in patients with pulmonary artery hypertension (PAH), unless required by co-morbidities, because no convincing data are available on the efficacy and safety of such drugs. However, real life patients are often different from those enrolled in big clinical trials, usually being older and having more comorbidities.