Role of bradykinin and nitric oxide in the cardioprotective action of angiotensin-converting enzyme inhibitors: Focus on Perindopril.

The involvement of endothelial dysfunction in all phases of the cardiovascular process makes it an important target for treatment, especially in hypertension. Antihypertensive treatments, in addition to their ability to lower blood pressure, should ideally have additional properties that specifically restore endothelial function. ON (nitric oxide) is essential for endothelial function and its production is enhanced both directly and indirectly through inhibition of angiotensin II production and reduction of bradykinin degradation by ACE inhibitors. Among the ACE inhibitors, Perindopril appears to have the greatest effects on bradykinin and has demonstrated efficacy on several markers of endothelial dysfunction, such as arterial stiffness and progression of atherosclerosis. Evidence from a series of large randomized controlled trials supports the use of Perindopril-based therapy for the treatment of hypertension to control its values and to reduce the risk of cardiovascular morbidity and mortality in a wide range of patients along the cardiovascular continuum.

Cardiol Ther https://doi.org/10.6084/m9.figshare.9896510. August 27, 2019

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