Role of ACE Inhibitors in Transforming Renin–Angiotensin System

ACE inhibitors and angiotensin receptor blockers (ARBs) are key RAAS inhibitors recommended for treating hypertension, heart failure, and diabetic nephropathy. Their discovery, rooted in the unexpected identification of a bradykinin peptide from snake venom, revolutionized cardiovascular treatment. ACE inhibitors, such as captopril, reduce the risk of stroke, myocardial infarction, and heart failure by promoting vasodilation and lowering blood pressure. Current guidelines advocate their use as first-line therapy, often combined with diuretics or calcium channel blockers. Studies show ACE inhibitors not only improve cardiovascular outcomes but also reduce the risk of diabetes, making them superior to beta blockers and calcium channel blockers in some cases. Furthermore, ACE inhibitors offer immunomodulatory effects by influencing bradykinin and substance P, impacting inflammation and immune function. This chapter delves into the mechanisms and therapeutic applications of ACE inhibitors, emphasizing their pivotal role in cardiovascular and metabolic diseases.