Role of Ace Inhibitors In Atherosclerosis

Abstract

Angiotensin converting enzyme (ACE) inhibitors are an important class of antihypertensive drugs which have been used in the treatment of cardiovascular diseases where hypertension is the main risk factor. In hypertensive patients, it has been observed that there is formation of atherosclerotic plaques.Circulating and local renin angiotensin system (RAS) have been involved in atherosclerotic process on the basis of experimental data showing the presence and specific actions of the components of this system in the vascular wall particularly, angiotensin II which participate in atherogenesis. ACE inhibitors prevent angiotensin II induced vascular proliferation and thereby thereby suppress the development of atherosclerosis in animals. It is also seen that blood pressure effects of ACE inhibitors could play a role in the antiatherosclerotic effect of these drugs. Other mechanisms involved could be blockade of the renin angiotensin system on sympathetic nervous activity, regulation of vascular growth factors and insulin sensitivity. Oxidative stress also plays an important part in the pathogenesis of hypertension and atherosclerosis. ACE inhibitors have been shown to have anti-oxidant activity and by their antihypertensive action , they can prevent atherosclerosis also. In this review, maximum information related to ACE inhibitors, hypertension and atherosclerosis has been compiled for the benefit of physicians and patients.