During the last few years, the use of angiotensin converting enzyme (ACE) inhibitors in the treatment of patients with cardiovascular diseases has been increasing. Captopril is the earliest oral ACE inhibitor and was marketed in 1977. The adverse effect most undesirable with vasodilators, particularly in patients with heart disease, is a reflex tachycardia. The absence of tachycardia with the possibility of binding free radicals is the comparative advantage of angiotensin converting enzyme inhibitors. Because of their positive hemodynamic effect, ACE inhibitors should be used as a supplement in the treatment of patients who need aortocoronary bypass. Their use does not exclude the intravenous administration of vasodilators, and only decreases the required therapeutic concentration of these drugs.
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