MANAGEMENT OF HYPERTENSION AND ITS SEQUELAE WITH ACE-INHIBITORS - BIOCHEMICAL, PHARMACOLOGICAL AND CLINICAL ASPECTS

ACE inhibitors are a widely prescribed class of drug for the managemen t of hypertension, Their therapeutic role in the treatment of heart fa ilure, diabetic nephropathy and post myocardial infarction with left v entricular dysfunction is steadily increasing. Although ACE inhibitors have a similar mechanism of action - namely, inhibition of circulator y ACE, thereby decreasing the formation of angiotensin II - individual members differ in their physicochemical properties, enzyme-binding ki netics, pharmacokinetic profile, organ-specific affinity and selectivi ty, as well as in their bradykinin potentiating effect. These factors play an important part in influencing the pharmacological profile of a n agent and its clinical efficacy, especially in the treatment of hype rtension. It is therefore prudent to take into account the existing ph armacological and clinically relevant differences between the individu al members of this drug class before making the decision to select a p articular ACE inhibitor for the long-term management of arterial hyper tension.