PMID: 2490816May 1, 1989Paper

Angiotensin converting enzyme inhibitors. Present and future

Hypertension
E D Frohlich

Abstract

The angiotensin converting enzyme (ACE)-inhibiting agents have emerged with the diuretic agents, beta-adrenergic receptor-blocking agents, and calcium antagonists as therapeutic options for major consideration during the initial treatment of hypertensive patients. These compounds antagonize a potent pressor mechanism underlying hypertensive disease. The ACE inhibitors curtail the generation of the potent octapeptide angiotensin II; in addition, degradation of the potent vasodilator bradykinin is inhibited. Hemodynamically, ACE inhibitors reduce arterial pressure through a decreased total peripheral resistance that is unassociated with reflex stimulation of the heart or expansion of intravascular volume. The arteriolar dilation accounting for the decreased vascular resistance seems to occur in each target organ of the disease. Unlike the direct-acting smooth muscle vasodilators or adrenergic inhibitors, ACE inhibitors dilate the efferent as well as the afferent glomerular arterioles and thereby reduce glomerular hydrostatic pressure and renal filtration fraction, even though renal blood flow and glomerular filtration rate are preserved. The ACE-inhibiting compounds not only reduce left ventricular afterload in hypertension but a...Continue Reading

Citations

Dec 1, 1989·Journal of the American College of Cardiology·G L Bakris, E D Frohlich
Dec 1, 1995·British Journal of Clinical Pharmacology·J R CockcroftJ M Ritter
Apr 1, 1993·British Journal of Pharmacology·P ArvolaI Pörsti
Sep 7, 2000·Journal of Clinical Pharmacology·E Basta, G L Bakris
Oct 13, 2005·Journal of Cardiovascular Pharmacology·Shane A Phillips, Julian H Lombard
Aug 5, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Mesut OktemPolat Dursun
Jul 18, 2000·The Journal of Surgical Research·J G QiuS M Levenson
Mar 25, 2000·The Journal of Thoracic and Cardiovascular Surgery·M Poullis
Nov 1, 1992·The American Journal of Emergency Medicine·C J FinleyA E Nunez
Mar 27, 2004·American Journal of Physiology. Heart and Circulatory Physiology·Shane A PhillipsJulian H Lombard
Mar 6, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Ivana JukicInes Drenjancevic

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