ACE inhibitors, or angiotensin-converting enzyme inhibitors, are a group of pharmaceuticals that are used primarily in treatment of arterial hypertension and congestive cardiac failure, in most cases as the drugs of first choice.
They work by inhibiting the transformation of angiotensin I to angiotensin II by blocking the angiotensin-converting enzyme in pulmonary endothelium and elsewhere.
These drugs lower arteriolar resistance and increase venous capacitance; increase cardiac output and index, stroke work, and volume; lower renovascular resistance; and lead to increased natriuresis (excretion of sodium in the urine).
Epidemiological and clinical studies have shown that ACE inhibitors reduce the progress of diabetic nephropathy independently from their blood pressure lowering effect. This action of ACE inhibitors is utilised in prevention of diabetic kidney failure. Interestingly, they are used even in diabetics with unelevated blood pressure with good results.
The ACE inhibitors are contraindicated in persons with bilateral Renal Artery stenosis
Other ACE inhibitors are called vasopeptidase inhibitors.
