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.