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ACE (Angiotensin Converting Enzyme) inhibitors
ACE inhibitors are commonly used to lower blood pressure. They do this by blocking
the action of an enzyme (ACE) that converts the inactive hormone angiotensin
I to the active hormone angiotensin II and is also responsible for the degradation
of bradykinin. The absence of angiotensin II and increased levels of bradykinin
results in a widening of the arteries, thereby causing a fall in blood pressure.
A treatment given to a patient in a study that is pharmacologically active eg,
8 mg was the active treatment in the EUROPA trial.
Angina / angina pectoris
Usually referred to as simply ‘angina’, this is a recurring pain
or discomfort in the chest that happens when some part of the heart does not
receive enough blood.
A chemical involved in the renin-angiotensin aldosterone system (RAAS), which
plays a key role in blood pressure regulation. A high level of angiotensin II
is responsible for narrowing blood vessels and raising blood pressure.
The name ‘atherosclerosis’ comes from the Greek words ‘athero’ (meaning
gruel or paste) and sclerosis (meaning hardness). It is a process in which the
deposits of fatty substances, cholesterol, cellular waste products, calcium and
other substances build up in the inner lining of an artery. It usually affects
large and medium-sized arteries.
The pressure of blood against the walls of the main arteries. Blood pressure
is measured in millimetres of mercury (mmHg) and is recorded when the ventricles
of the heart are contracting (systolic pressure) and relaxing (diastolic pressure).
Bradykinin is a protein found in blood plasma which has a powerful influence
in dilating or relaxing the blood vessels, thereby decreasing blood pressure,
but also having protective properties on the vessel walls.
Referring to the heart.
A failure of the heart to pump blood, resulting in the loss of effective circulation.
The bodily system consisting of the heart, blood vessels, and blood that circulates
through the body, transporting nutrients and oxygen to the tissues and removing
Something that is of, or relating to, the heart e.g., the coronary arteries supply
blood to the muscles of the heart.
Artery Bypass Graft (CABG)
An operation using arterial or venous conduits inserted between aorta and the
coronary artery beyond the narrowing.
Artery Disease (CAD)
The is the most common form of heart disease, in which the coronary arteries
become narrowed or clogged and cannot supply enough blood to the heart.
Heart Disease (CHD)
See coronary artery disease.
The pressure of blood when the ventricles of the heart are relaxing and refilling.
This is when blood pressure is at its lowest.
An intervention study where two or more groups of patients are deliberately given
different treatments and neither the patient or the doctor responsible for the
treatment is aware of which treatment is being administered.
A thin monolayer of cells lining the inside of all blood vessels working as a
selective barrier with metabolic and secretory activity. Its dysfunction, present
in many pathological cases, is implicated in the manifestation of cardiovascular
EUROPA (European Trial on the Reduction of Cardiac
Events with Perindopril in Stable Coronary Artery Disease)
The first study to assess the long-term effects (over four years) of ACE-inhibitor
therapy with perindopril on the reduction of cardiac events in patients with
proven stable coronary artery disease with/without myocardial ischaemia but without
heart failure, irrespective of their age or risk profile.
The effectiveness of a drug.
See myocardial infarction.
An inability of the heart to pump enough blood to sustain normal bodily functions.
High blood pressure
When the blood pressure goes above the normal range expected in a particular
A method of viewing the coronary arteries by threading a tiny ultrasound ‘camera’ into
the coronary arteries to give a valuable cross-sectional view from the inside-out
showing a view of the artery wall.
The loss of an adequate supply of oxygenated blood, usually due to obstruction
of the arterial blood supply or inadequate blood flow , leading to a lack of
oxygen in the tissue and causing serious damage to the end organs (brain, heart,
The incidence of a disease in a population.
The death rate: the ratio of the total number of deaths to the total population.
The medical term for heart attack, which occurs when the blood supply to part
of the heart muscle itself – the myocardium – is severely reduced
or stopped, resulting in the death of a segment of the heart muscle.
A condition where the heart muscle is deprived of oxygen due to poor blood circulation.
Coronary Intervention (PCI)
An intervention with introduction of catheters and balloons to dilate coronary
A medication that belongs to a class of drugs known as angiotensin converting
enzyme (ACE) inhibitors. It is very effective and well tolerated, has a long
duration of action, and can be given as a once daily dose. Perindopril is indicated
in hypertension and heart
A study where one of the treatments given to patients is inactive i.e., a placebo.
This placebo is usually compared with the active treatment being evaluated in
The number of people with a condition in the population at risk at a given point
Quantitative Coronary Angiography (QCA)
QCA is an imaging technology that uses X-rays to view the arteries of the heart
in three dimensions. Angiography reveals the status of the coronary arteries
and their branches, which supply blood and nutrients to the cells of the heart.
Patients entering the study are randomly assigned to receive a particular treatment.
The likelihood of receiving one or other study treatment is identical. This is
to avoid any selection bias that may affect the impartiality of the study results.
Aldosterone System (RAAS)
The RAAS is a critical component in regulating blood pressure and fluid balance
in the body. Evidence suggests that it is also involved in the development of
Intervention to restore blood flow. Common forms of revascularisation include
coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty
(PTCA), with or without the implantation of coronary prosthesis (stent, a tube
used to keep blood vessels open to maintain blood flow).
Systolic blood pressure
This represents the pressure of the blood when the heart contracts. This is when
the blood pressure is highest.
A period before randomisation that can be used to increase the efficiency of
the trial e.g., by examining patients’ tolerance to the study medication
or their compliance to taking their treatment.
These are studies nested within the main study, which provide an opportunity
to investigate the study population to answer more than the original question
driving the rationale for the main study.
A cardiovascular disease in which a blood vessel bringing oxygen and nutrients
to the brain bursts or is clogged by a blood clot or some other particle. Deprived
of oxygen, nerve cells in the brain cannot function and die, stopping the function
of the parts of the body they control.
Ischaemic Attacks (TIA)
A minor reversible form of stroke.