Pharmacology Question

[IMG SURVIVOR]

A 68-year-old man has stable mild exertional angina. He underwent coronary artery bypass graft surgery 2 years ago. His heart rate is 60/min, blood pressure is 120/60mm Hg, and left ventricular function and hemoglobin are normal. He takes maximally tolerated doses of nitrates and β-blockers.
Which of the following medications would decrease the likelihood of a cardiovascular event in this patient?
A. Angiotensin-converting enzyme inhibitors
B. Angiotensin receptor blockers
C. Digoxin
D. Dihydropyridine calcium blockers
E. Calcium channel blockers

[hunteradam07]

If Cardiovascular events meaning MI, I think the answer is A/B, and I go with B cuz of less side effects: Dry cough! My logic is to decrease remodeling of heart, which is decrease demand of O2 on the heart tissue=Decrease MI risk. So I say B.

[paopaolong]

I go E.
What is the answer?

[thomasg2]

Go for A

ACEI inhibit remodelling of heart, vasodilating due to inhibition of the vasoconstricter Ang-II plus increase levers of Bradykinin which also is a potent vasod., inhibit aldosterone release, and decrease mortality over time. Do not have much effect on Hr and CO.

ARB are given to p with negative side effects to ACEI like angioedema due to increased bradykinin levels.

[memphis]

I go with A. Ca blocker may not be right, since the heart rate is pretty low already

[OasisMan]

arent CCBs the drug of choice for exertional angina?

[statiastudent347]

ace inhinitors for sure , final answer , lolol
only thing really proven to decrease mortality in cvs disease
what u got?

[Gottlima]

I agree with ******. ACE Inhibitors are the treatment of choice. There's no reason to start with an ARB unless they've failed the ACE Inhibitor due to SE's. Also, ARBs are less well-proven in reducing adverse outcomes compared to ACE Inhibitors.

[loka1282]

I would go for A