, Volume 23, Issue 2, pp 109-111
Date: 13 Nov 2008

Cardiovascular Outcomes and Angiotensin Converting Enzyme Inhibitors: Beyond Blood Pressure Control

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Atherosclerosis and its complications, stroke, coronary artery disease and peripheral arterial disease, remain the leading cause of mortality and morbidity and are increasing in incidence in the developing world [1]. Multiple mechanisms are associated with the development of atherosclerosis but since the discovery of renin by Tigerstedt and Bergman [2] more that 100 years ago, the renin–angiotensin system (RAS) has been focus of intensive investigative efforts. Although our understanding of the RAS and the development of atherosclerosis has grown increasingly complex, inhibition of the RAS with an angiotensin-converting enzyme inhibitor (ACE-I) has become a firmly established therapeutic approach for reducing morbidity and the risk of death across a broad spectrum of cardiovascular diseases based on multiple, well-conducted, randomized clinical outcome trials (RCT) [36]. The benefits of ACE-I on clinical outcomes are due in part to blood pressure control but other mechanisms beyond bl