The Enduring Legacy of Renin-Angiotensin System Blockade
The cardiovascular treatment paradigm was revolutionized in the late 20th century with the introduction of Angiotensin-Converting Enzyme (ACE) inhibitors. These agents work by preventing the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, effectively relaxing blood vessels and reducing the workload on the heart. Today, they remain a foundational therapy for hypertension, heart failure, and diabetic nephropathy. As global healthcare systems shift toward value-based care, the proven efficacy and low cost of these established agents continue to make them the first-line defense against the rising tide of non-communicable diseases.
Hypertension is often called the "silent killer" because it frequently presents no symptoms until a major cardiac event occurs. ACE inhibitors have become indispensable in managing this epidemic by not only lowering blood pressure but also providing organ-protective benefits. By inhibiting the ACE enzyme, these drugs also increase levels of bradykinin, a protein that further helps dilate blood vessels.…