ABSTRACT
Introduction Ramipril (see Scheme 1) contains not less than 98.0% of C23H32N2O5; (2S,3aS,6aS)-1-[(2S)-2-[[(2S)-1-ethoxy-1-oxo-4-phenylbutan-2-yl]amino] propanoyl]-3,3a,4,5,6,6a-hexahydro-2H-cyclopenta[d]pyrrole-2 carboxylic acid. It belongs in a class of drugs called angiotensin converting enzyme (ACE) inhibitors which are used for treating high blood pressure and heart failure and for preventing kidney failure due to high blood pressure and diabetes. ACE is important because it produces the protein, angiotensin II. Angiotensin II contracts the muscles of most arteries in the body, including the heart, thereby narrowing the arteries and elevating the blood pressure. In the kidney, the narrowing caused by angiotensin II also increases blood pressure and decreases the ow of blood. ACE inhibitors such as ramipril lower blood pressure by reducing the production of angiotensin II, thereby relaxing the arterial muscles and enlarging the arteries. e enlargement of the arteries throughout the body reduces the blood pressure against which the heart must pump blood, and it becomes easier for the heart to pump blood. e arteries supplying the heart with blood also enlarge. is increases the ow of blood and oxygen to the heart, and this improves further the ability of the heart to pump blood. e eects of ACE inhibitors are particularly benecial to people with congestive heart failure. In the kidneys, the enlargement of the arteries also reduces blood pressure and increases blood ow.
