ABSTRACT
Introduction The angiotensin converting enzyme (ACE) inhibitors have made a spectacular impact on cardiovascular therapeutics, almost certainly beyond the expectations of those who developed them. The ACE inhibitors are widely used in hypertension generally and even more in diabetic hypertensives. They have also assumed a crucial role in the treatment of heart failure and in secondary prevention following myocardial infarction (MI). It has recently been suggested that virtually all patients with atherosclerosis are potential candidates for ACE inhibitors, in the absence of contra-indications and intolerance.1
Although of course hypertension and coronary artery disease commonly co-exist, this chapter will not deal with ACE inhibitors as antihypertensive drugs but will focus on the basic mechanisms and the practicalities of their other uses. Ideas in this area have changed greatly since 1990, as it has become clear that angiotensin II has a much wider range of cardiovascular effects than had been supposed.
