ABSTRACT

The indications for angioten in-converting enzyme (ACE) inhibitors have widened considerably in scope since they were fir t introduced for the treatment of hyperten ion. A serie of landmark studie tarting in 1987 with CO SE SUS (CO SENSUS Trial Study Group, 1987) showed that ACE inhjbitors should be u ed in all grade of heart failure as ociated with left ventricular dysfunction. It i now al o clear that the ACE inhibitor reduce the rate of progression of renal failure in both diabetic and non-diabetic renal disease, effects that appear to go beyond their effect on blood pre sure. Ongoing studies will determine whether the mortality benefit seen in heart failure transfer to hypertension, wi ll a e the role of ACE inhibition in prevention of cardiova cular events in high-risk patient , and will clarify the potential effects of ACE inhibition on recurrent myocardial infarction (Ml) and athero clero is.