Ventralink Medication Education Series

ACE Inhibitors & ARBs • Article 1 of 6

The Discovery That Changed Heart Medicine

Understanding How ACE Inhibitors and ARBs Protect Your Heart, Blood Vessels, and Kidneys

Why Your Doctor Prescribed Lisinopril, Losartan, or Similar Medications—And How They Work

The Bottom Line

ACE inhibitors and ARBs are among the most important medications in modern medicine. Over 35 years of research involving hundreds of thousands of patients has proven these medications don't just lower blood pressure—they actively protect your heart, blood vessels, and kidneys. For many patients, taking one of these medications is like having a security system that prevents damage before it happens.

A Hidden System Running in Your Body

Right now, as you read this, there's a hormone system working quietly in your body. It's called the renin-angiotensin-aldosterone system—but you can think of it as your body's blood pressure control center.

This system has one main job: make sure blood is flowing strongly enough to reach every part of your body. When you're dehydrated, when you stand up quickly, when you need to run from danger—this system kicks in to keep your blood pressure up.

Here's how it works in simple terms:

Step 1

Your kidneys sense low blood pressure and release a hormone called renin

Step 2

Renin triggers a chain reaction that creates a powerful chemical called angiotensin II

Step 3

Angiotensin II does two things: it makes your blood vessels squeeze tighter and tells your kidneys to hold onto salt and water

Result

Blood pressure goes up—more fluid in tighter pipes equals higher pressure

When This System Works Against You

This blood pressure system evolved to help us survive emergencies. The problem is, in modern life, it can become overactive. Instead of occasionally raising your blood pressure when needed, it stays "on" all the time.

Think of it like a thermostat stuck in the "on" position. The heat never turns off, even when the house is already warm enough. Over time, this causes damage:

Your Heart	Has to pump harder against tighter blood vessels. Over time, the heart muscle thickens and weakens—like any muscle that's constantly overworked.
Your Blood Vessels	The constant high pressure damages the inner lining, making it easier for cholesterol to build up and for clots to form. This can lead to heart attacks and strokes.
Your Kidneys	The delicate filtering units in your kidneys get damaged by high pressure. This is especially dangerous for people with diabetes, where kidney damage is already a risk.

How ACE Inhibitors and ARBs Help

In the 1970s and 1980s, scientists figured out how to block this overactive system. They developed two types of medications:

ACE Inhibitors	ARBs
Names end in "-pril" (lisinopril, enalapril, ramipril)	Names end in "-sartan" (losartan, valsartan, candesartan)
Block the enzyme that creates angiotensin II (stop it from being made)	Block the receptors where angiotensin II attaches (stop it from working)
May cause a dry cough in some people (about 10-15%)	Less likely to cause cough; often prescribed when ACE inhibitors aren't tolerated

Both types of medication achieve the same goal: they turn down the volume on that overactive blood pressure system. Your blood vessels relax, your heart doesn't have to work as hard, and your kidneys are protected from damage.

35 Years of Proof: What the Research Shows

Between 1987 and today, researchers have conducted dozens of major studies involving hundreds of thousands of patients. These aren't small experiments—they're rigorous scientific trials that changed how doctors practice medicine worldwide.

The research tells a clear story: these medications do much more than lower blood pressure. They actively protect your body from damage in ways that save lives.

What Decades of Research Have Proven

For people with heart failure: These medications can extend life by years and dramatically reduce hospitalizations.

After a heart attack: Starting these medications within days helps prevent the heart from weakening further.

For people at high risk: Even without heart failure, these medications prevent heart attacks and strokes in people with diabetes or existing heart disease.

For kidney protection: In people with diabetes, these medications can slow or prevent kidney failure.

What This Means For You

If your doctor has prescribed an ACE inhibitor or ARB, they're not just treating a number on a blood pressure monitor. They're giving you medication that has been proven—in study after study—to:

✓Reduce your risk of dying from heart disease
✓Prevent or slow down heart failure
✓Protect your heart after a heart attack
✓Lower your chance of having a stroke
✓Slow down kidney damage, especially if you have diabetes
✓Protect your blood vessels from long-term damage

The next articles in this series will take you through the specific research for each condition. You'll see exactly how these studies were done, how many people benefited, and what the numbers mean for someone like you.

Understanding Your Medication

Knowledge is power when it comes to your health. When you understand why you're taking a medication—not just that you should take it—you're more likely to take it consistently. And with ACE inhibitors and ARBs, consistent use is what delivers the protection these medications provide.

Quick Reference: Common ACE Inhibitors and ARBs

You might recognize your medication in one of these lists. All medications in each category work similarly—if one doesn't suit you, another in the same category often will.

ACE Inhibitors ("-pril")

Lisinopril (Zestril, Prinivil)
Enalapril (Vasotec)
Ramipril (Altace)
Captopril (Capoten)
Benazepril (Lotensin)
Perindopril (Aceon)
Quinapril (Accupril)

ARBs ("-sartan")

Losartan (Cozaar)
Valsartan (Diovan)
Candesartan (Atacand)
Irbesartan (Avapro)
Telmisartan (Micardis)
Olmesartan (Benicar)
Azilsartan (Edarbi)