Angiotensin converting enzyme inhibition

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Because it affords physicians the only known mechanism that blocks the activity of the renin-angiotensin-aldosterone system, angiotensin converting enzyme (ACE) inhibition represents a distinct advantage for many patients with hypertension or congestive heart failure. Drawing on an abundance of favorable trial and clinical data, the author asserts that captopril, the only ACE inhibitor as yet approved for clinical use, is an effective oral antihypertensive agent and the vasodilator of choice for chronic heart failure refractory to digitalis and diuretic therapy. Moreover, he notes that its side effect profile appears to be acceptable and, in fact, has “narrowed considerably” despite the drug's widespread use. Preliminary evidence suggests that this also holds true for enalapril and the other ACE inhibitors that are currently under Investigation.