Angiotensin-Converting Enzyme Inhibitors (ACE) in Congestive Heart Failure

To the Editor — Deedwania1presented an excellent review on the use of ACE inhibitors in congestive heart failure, but I do not believe there is enough data to support his conclusion that ... a short-acting ACE inhibitor such as captopril may be preferred for the treatment of selected patients with CHF [congestive heart failure] to minimize these risks. Although he had mentioned the interim report of the multicenter lisinoprilcaptopril congestive heart failure study group,2his article omitted their final report3that showed that lisinopril was superior in improving ejection fraction, functional capacity, and quality of life and that it produced fewer serious adverse experiences compared with captopril. At present, the data are inconclusive regarding the superiority of one ACE inhibitor over other agents, and absolutely agree with Jessup's opinion that ... unfortunately, until more research is accomplished, the choice of an ACE inhibitor for the patient with heart