It is scientifically confirmed that not only in recirculated blood, but also in heart, brain and kidney tissues, angiotensin-converting enzyme and angiotensin II are produced. The latter can cause vasoconstriction and promote the release of some other substances that can cause vasoconstriction, and these can cause vasoconstriction and increase blood pressure. Scientific experiments have also confirmed that angiotensin II can also cause organic changes such as vascular thickening, heart enlargement and the appearance of atherosclerotic plaques. Angiotensin-converting enzyme inhibitors inhibit the production of angiotensin II by inhibiting the action of angiotensin-converting enzyme to produce blood pressure reduction and protection of the heart, brain and kidney. Angiotensin-converting enzyme inhibitors produce the following effects by inhibiting blood ring blood pressure and angiotensin II production in the heart, brain, kidney and other tissues: 1. Dilatation of blood vessels and reduction of peripheral vascular resistance, resulting in a decrease in blood pressure; 2. Decrease in angiotensin II levels, reduced action on sympathetic constrictor fiber endings, and reduced release of norepinephrine, which acts directly on the central nervous system and inhibits sympathetic activity, also producing antihypertensive effect; 3, inhibit and reverse cardiovascular remodeling, protect target organs; 4, inhibit the formation of atheromatous plaque, stabilize plaque, exert anti-atherosclerotic effect, and improve vascular endothelial function, reduce the activity of thrombinogen activator inhibitor, maintain normal fibrinolytic balance, inhibit intravascular thrombosis; 5, reduce aldosterone synthesis, water and sodium retention effect is weakened, reduce cardiac load, while Reduce the adverse effects of aldosterone on the cardiovascular system, ultimately lowering blood pressure and protecting the heart, brain and kidneys; 6, reduce urinary protein excretion, reduce interstitial fibrosis and delay the deterioration of renal function. Angiotensin-converting enzyme inhibitors are indicated for four categories of patients 1.
Hypertension: clinical studies have confirmed that angiotensin-converting enzyme inhibitors can significantly reduce blood pressure in patients with primary hypertension of grade 1 and 2, and in combination with other anti-hypertensive drugs, they also have better antihypertensive efficacy in patients with grade 3 hypertension; 2.
Hypertension combined with heart failure: International large clinical trials have confirmed that angiotensin-converting enzyme inhibitors can improve the survival rate of patients with heart failure, prolong the life span of patients and improve the prognosis. It can be the drug of choice for hypertension combined with heart failure; 3.
Left ventricular hypertrophy or vascular remodeling: angiotensin-converting enzyme inhibitors can reverse hypertension-induced left ventricular hypertrophy and cardiovascular remodeling, and this protective effect of it has both the effect of angiotensin-converting enzyme inhibitors in lowering blood pressure and the protective effect played by the non-hypertensive effect outside of blood pressure lowering; 4.
Renal insufficiency and diabetic nephropathy: angiotensin-converting enzyme inhibitors have a protective effect on the kidney and are the first choice for the treatment of patients with hypertension with renal insufficiency. Application should be started with a small dose and gradually increased. When blood creatinine is less than 3.0 mg/dL, blood creatinine and blood potassium should be closely monitored; when blood creatinine is greater than 3.0 mg/dL, use should be stopped.