Are ACE Inhibitors a “Magic Bullet” Against Oxidative Stress?

Outcomes Prevention Eval- uation (HOPE) study, 1,2 as well as the Study to Evaluate Carotid Ultrasound Changes in Patients Treated With Ramipril and Vitamin E (SECURE), 3 demonstrated that treatment with an ACE inhibitor but not vitamin E had beneficial effects on the prognosis and progression of atherosclerosis.In these studies, long-term ACE inhibition significantly reduced the rate of death, myocardial infarction, and stroke and reduced the intima-to-media ratio of carotid arteries in patients at high risk for cardiovascular events.It is likely that these findings will have wide-ranging implications for the treatment of cardiovascular disease, and the contrasting results with respect to ACE inhibitors and vitamin E provide an opportunity to revisit the role of oxidative stress in vascular disease.