title: Pathophysiologic and therapeutic importance of tissue ACE: a consensus report.
abstract: Angiotensin-converting enzyme (ACE) activation and the de novo production of angiotensin II contribute to cardiovascular disease through direct pathological tissue effects, including vascular remodeling and inflammation, as well as indirect action on nitric oxide bioavailability and its consequences. The endothelium plays a pivotal role in both vascular function and structure; thus, the predominant localization of ACE to the endothelium has implications for the pathobiology of vascular disease, such as coronary artery disease. Numerous experimental studies and clinical trials support the emerging realization that tissue ACE is a vital therapeutic target, and that its inhibition may restore endothelial function or prevent endothelial dysfunction. These effects exceed those attributable to blood pressure reduction alone; hence, ACE inhibitors may exert an important part of their effects through direct tissue action. Pharmacologic studies show that while ACE inhibitors may differ according to their binding affinity for tissue ACE the clinical significance remains to be determined.
authors.affiliation: Department of Medicine, Brigham Women's Hospital, Boston, MA 02115, USA. VDZAU@partners.org
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Dzau
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bernstein
authors.forename: David
authors.initials: D
authors.lastname: Celermajer
authors.forename: Jerome
authors.initials: J
authors.lastname: Cohen
authors.forename: Björn
authors.initials: B
authors.lastname: Dahlöf
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.forename: Javier
authors.initials: J
authors.lastname: Diez
authors.forename: Helmut
authors.initials: H
authors.lastname: Drexler
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
authors.forename: Wiek
authors.initials: W
authors.lastname: Van Gilst
authors.forename: Lennart
authors.initials: L
authors.lastname: Hansson
authors.forename: Burkhard
authors.initials: B
authors.lastname: Hornig
authors.forename: Ahsan
authors.initials: A
authors.lastname: Husain
authors.forename: Colin
authors.initials: C
authors.lastname: Johnston
authors.forename: Harold
authors.initials: H
authors.lastname: Lazar
authors.forename: Eva
authors.initials: E
authors.lastname: Lonn
authors.forename: Thomas
authors.initials: T
authors.lastname: Lüscher
authors.forename: John
authors.initials: J
authors.lastname: Mancini
authors.forename: Albert
authors.initials: A
authors.lastname: Mimran
authors.forename: Carl
authors.initials: C
authors.lastname: Pepine
authors.forename: Ton
authors.initials: T
authors.lastname: Rabelink
authors.forename: Willem
authors.initials: W
authors.lastname: Remme
authors.forename: Luis
authors.initials: L
authors.lastname: Ruilope
authors.forename: Marcel
authors.initials: M
authors.lastname: Ruzicka
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.forename: Karl
authors.initials: K
authors.lastname: Swedberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Unger
authors.forename: Douglas
authors.initials: D
authors.lastname: Vaughan
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001682:Biological Availability; D001920:Bradykinin / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D053818:Chymases; D002986:Clinical Trials as Topic; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D009569:Nitric Oxide / Q000378:metabolism; D009928:Organ Specificity; D007703:Peptidyl-Dipeptidase A / Q000378:metabolism*; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D012697:Serine Endopeptidases / Q000378:metabolism
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D009569:Nitric Oxide; D007703:Peptidyl-Dipeptidase A; D012697:Serine Endopeptidases; D053818:Chymases; D001920:Bradykinin