Angiotensin converting enzyme inhibitors and angiotensin II receptor blockers: which class of drugs should be preferable for patients with cardiovascular pathology?

The article presents a comparative analysis on the effectiveness of two classes of drugs angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin II type 1 receptor blockers (ARB II) for patients with cardiovascular diseases: arterial hypertension, heart failure, coronary heart disease, ischemic brain disease. The advantage of ACE inhibitors over ARB II in reducing the risk of general and cardiac mortality, myocardial infarction, cerebral strokes, chronic heart failure, chronic kidney disease has been established. The positive effect of ACE inhibitors on the course of a new coronavirus infection is also demonstrated. The mechanisms of action of both classes of drugs are proposed for discussion, which substantiate the advantage of ACE inhibitors over ARB II from the standpoint of pathophysiology in relation to controlling major cardiovascular risks.