The renin-angiotensin system: a review of trials with angiotensin-converting enzyme inhibitors and angiotensin receptor blocking agents

Angiotensin-converting enzyme (ACE) inhibitors have been very successful in patients with vascular disease, in particular for hypertension, left ventricular dysfunction and vascular protection. Angiotensin receptor blocking drugs (ARBs) were developed later and differ from ACE inhibitors in several ways. We are now beginning to see the results of large studies of ARBs in high-risk patients and some head-to-head comparisons between these two classes of drugs which reduce the actions of angiotensin H. This review considers these trials under the headings of heart failure, hypertension, renal function, and high-risk cardiovascular disease/coronary heart disease.