What dose of ACE inhibitor should I use for secondary prevention of myocardial infarction?
• Titrate upwards (every 1–2 weeks) to the target dose or maximum tolerated dose. • For people with preserved left ventricular function: • Starting doses — lisinopril: 5 mg once a day; perindopril: 4 mg once a day; ramipril: 2.5 mg twice a day. If the person is hypotensive or elderly, use a lower starting dose. • Target doses — lisinopril 10 mg once a day; perindopril: 8 mg once a day; ramipril: 5 mg twice a day. • For people with left ventricular dysfunction (with or without symptoms): titrate up to the target dose for heart failure. See the CKS topic on Heart failure – chronic.
