Angiotensin II-mediated vasoconstriction in chronic congestive heart failure, and response to converting enzyme inhibition.

To judge the efficacy of converting enzyme inhibitors in the management of congestive heart failure, it is necessary to interpret this in the context of the factors that stimulate renin release and the subsequent formation of angiotensin and aldosterone. The pharmacologic properties of individual converting enzyme inhibitors must be considered, and the alterations in both renin angiotensin activity and long-term converting enzyme inhibition that interact in complementary or offsetting ways to influence the long-term therapeutic result must be understood.