ACE Inhibitors

Captopril was the first ACE inhibitor developed and was considered a breakthrough both because of its novel mechanism of action and also because of the revolutionary development process - Ankala Subbarao

ACE Inhibitors
ACE Inhibitors

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From snake venom to ACE inhibitor — the discovery and rise of captopril

In the early 1980s, hypertension conferences were routinely enlivened by the poisonous Brazilian viper, Bothrops jararaca. With its striking zig-zag markings and aggressively protruding tongue, images of the snake were a welcome break from graphs and tables in presentations about captopril — the first of the angiotensin-converting enzyme (ACE) inhibitors, whose effects on blood pressure mechanisms mimicked those of the snake’s venom. When the cardiovascular juggernaut alighted in Sao Paulo, Brazil, for a major congress in 1984, there was even an opportunity for delegates to visit a snake farm and see the beast in all its glory.

“The discovery of the ACE inhibitors and the creation…

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 From snake venom to ACE inhibitor — the discovery and rise of captopril

The discovery of the ACE inhibitors and the creation of captopril was one of the really great advances in cardiovascular medicine, alongside beta blockers, calcium channel blockers and statins.


Angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are mainly used to treat high blood pressure (hypertension) and heart failure. They can also reduce the risk of kidney damage in people with diabetes.

Cough–A nuisance side effect of ACE inhibitors

Another much less common adverse effect of ACE inhibitors is angioedema. However, angioedema is not a mere nuisance adverse effect as is cough, but it can be fatal. The incidence of angioedema has been shown to vary a great deal, and the PDR does not give us any reliable information in this regard.

Differences in the Clinical Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Critical Review of the Evidence

Accordingly, we should aim at establishing a combination treatment based on ACE inhibitors in patients with cardiovascular co-morbidities (CAD, CHF, post-AMI). Rather, ARB agents may be prescribed to patients who do not tolerate ACE inhibitors.


ACE inhibitors prevent the body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme. This has a variety of effects but essentially relaxes blood vessels and helps to reduce the amount of water re-absorbed by the kidneys.

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