Pathophysiologic and therapeutic importance of tissue ACE: A consensus report

Victor J. Dzau*, Kenneth Bernstein, David Celermajer, Jerome Cohen, Björn Dahlöf, John Deanfield, Javier Diez, Helmut Drexler, Roberto Ferrari, Wiek Van Gilst, Lennart Hansson, Burkhard Hornig, Ahsan Husain, Colin Johnston, Harold Lazar, Eva Lonn, Thomas Lüscher, John Mancini, Albert Mimran, Carl PepineTon Rabelink, Willem Remme, Luis Ruilope, Marcel Ruzicka, Heribert Schunkert, Karl Swedberg, Thomas Unger, Douglas Vaughan, Michael Weber

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

127 Scopus citations

Abstract

Angiotensin-converting enzyme (ACE) activation and the de novo production of angiotensin II contribute to cardiovascular disease through direct pathological tissue effects, including vascular remodeling and inflammation, as well as indirect action on nitric oxide bioavailability and its consequences. The endothelinm plays a pivotal role in both vascular function and structure; thus, the predominant localization of ACE to the endothelinm has implications for the pathobiology of vascular disease, such as coronary artery disease. Numerous experimental studies and clinical trials support the emerging realization that tissue ACE is a vital therapeutic target, and that its inhibition may restore endothelial function or prevent endothelial dysfunction. These effects exceed those attributable to blood pressure reduction alone; hence, ACE inhibitors may exert an important part of their effects through direct tissue action. Pharmacologic studies show that while ACE inhibitors may differ according to their binding affinity for tissue ACE the clinical significance remains to be determined.

Original languageEnglish (US)
Pages (from-to)149-160
Number of pages12
JournalCardiovascular Drugs and Therapy
Volume16
Issue number2
DOIs
StatePublished - 2002

Keywords

  • Angiotensin-converting enzyme inhibitors
  • Cardiovascular disease
  • Endothelial dysfunction
  • Tissue ACE

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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