ACE Inhibitors

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Angiotensin converting enzyme inhibitors (ACEI) are the first class of antihypertensive agents developed based on a clear understanding of arterial hypertension, a major cause of morbidity and mortality globally. CAPTOPRIL, the prototype of the "PRIL" family, faced significant challenges during clinical development due to serious side effects reported in prominent journals, leading to the possibility of its withdrawal from investigation. However, after careful re-examination of patient data and dose adjustments, CAPTOPRIL's clinical use proved revolutionary. This prototype and other "PRIL" family members sparked extensive research into ACEI interactions with the kinin, endothelin, and nitric oxide systems, as well as the roles of various receptors in their pharmacological actions. This research paved the way for new pharmacological agents, including angiotensin receptor antagonists and, more recently, neutral endopeptidase inhibitors. In the near future, bradykinin receptor antagonists are expected to emerge, further modulating the pharmacological effects of ACEI.