Harvard Heart Letter

Angiotensin inhibitor or blocker?

For controlling blood pressure, an ACE inhibitor is a good place to start.

Doctors are often quick to prescribe new drugs even when the "old" ones work perfectly fine. That has certainly been the case with newer angiotensin receptor blockers (ARBs) and older ACE inhibitors, two classes of drugs commonly used to treat high blood pressure (hypertension). Both drugs target a molecule known as angiotensin II, but in different ways.

ACE inhibitors block the conversion of inactive angiotensin I into active angiotensin II. Less angiotensin II in circulation gives blood vessels a chance to relax and widen, easing the passage of blood. ACE inhibitors also protect the kidneys in people with diabetes and kidney trouble, and they slow the dangerous cardiac remodeling that often occurs with heart failure. The first ACE inhibitor was approved in 1981.

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