Could the Pharmacological Differences Observed Between Angiotensin II Antagonists and Inhibitors of Angiotensin Converting Enzyme be Clinically Beneficial

Over the past several years, angiotensin I converting enzyme (ACE) inhibitors, compounds that block the formation of angiotensin I1 (ANG II), have become widely used in the treatment of cardiovascular disease. Recently, a new class of orally active, non-peptide inhibitors of the renin-angiotensin system, the ANG I1 receptor antagonists have also become available. Since both classes of compounds block the renin-angiotensin system, although at different sites, it remains to be determined whether blockade of ANG I1 receptors will have any specific advantage over inhibition of ACE. The following review assesses the actions of ANG I1 antagonists and suggests ways in which blockade of ANG I1 receptors may differ both pharmacologically and clinically from inhibition of ACE. Abbreviations: ACE - angiotensin I converting enzyme; ANG - angiotensin.