During 1990 quinapril (Accupro – Parke-Davis), perindopril (Coversyl – Servier) and ramipril (Tritace – Hoechst) joined captopril, enalapril and lisinopril1, 2 as inhibitors of angiotensin-converting enzyme (ACE) for the treatment of hypertension. Of the newer drugs only quinapril is currently licensed for use in heart failure. Claims, such as ‘a unique pharmacokinetic profile’ for quinapril, and of ‘high performance’ for perindopril, and the promotional emphasis on evidence that perindopril reverses hypertensive structural change in arteries, need critical examination.
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