We appreciate the discussion provided by several readers and hope to highlight and clarify several key points. Foremost, achieving optimal blood pressure control, independent of the specific agent or agents selected, is critical to effective risk reduction. Some of the important clinical questions remaining are whether, at an identical level of blood pressure control, ACE inhibitors provide additional protection against atherothrombotic events compared with other antihypertensive agents, particularly ARBs, and whether ACE inhibition reduces risk independent of its blood pressure–lowering effects.
Jacoby DS, Rader DJ. Vascular Protection of ACE Inhibitors—Reply. Arch Intern Med. 2003;163(22):2792-2793. doi:10.1001/archinte.163.22.2791-a