title: Use of ACE inhibitors in the treatment of cardiovascular disease.
abstract: ACE inhibitors have been available by prescription since the marketing of captopril in the early 1980s. Since that time, six additional ACE inhibitors have been marketed, four of which received approval from the Food and Drug Association in 1991. All but one of the new ACE inhibitors are carboxylic-acid compounds, and all of them maintain a pro-drug metabolic pathway. Initially, ACE inhibitors were approved only for the control of high blood pressure. More recently, captopril and enalapril have been approved for use in congestive heart failure. In 1988, ACE inhibitors were one of the recommended first-line therapies for mild-to-moderate hypertension. Their use in patients with hypertension has steadily increased, most likely because of their minimal effect on coexistent cardiovascular risk factors. In CHF, ACE inhibitors are the only single drug class that has been shown to reduce mortality and hospitalizations due to the disease without concomitant administration of another drug. ACE inhibitors are clearly drugs that should be used early in the treatment of most patients with CHF. Differences between ACE inhibitors are often difficult to define. As information regarding the clinical utility of tissue ACE inhibition is unveiled, the ability to use a selected ACE inhibitor based on individual patient characteristics may increase. The future for ACE inhibition looks promising and the cumulative clinical value of ACE inhibition appears to be just beginning.
authors.forename: J G
authors.initials: JG
authors.lastname: Gums
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D004347:Drug Interactions; D006333:Heart Failure / Q000188:drug therapy; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors