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The goal of this chapter is to pull together the various threads of the story of ACE inhibitors and weave a revealing fabric. They shared the Nobel Prize for Medicine or Physiology in 1988. The discovery of captopril followed the earlier work of James Black, Gertrude Elion, and George Hitchings, pioneers in the formulation of the principles of drug design and treatment. Second, captopril was among the first drugs approved for use in clinical medicine discovered by a process of rational drug design, as opposed to a more-or-less random hunt for molecules having promise of use in human medicine. Later, I explain what ACE does, and perhaps the name will make sense then. The names of enzymes reflect an effort to describe what they do, and the names are often complicated. ACE is the chemical acronym for angiotensin converting enzyme. This new class is known as ACE inhibitors. First, it is the pioneer drug in a new class of treatments for high blood pressure and other cardiovascular problems. Its patent life has long since expired and it is available as a generic drug. Captopril was marketed worldwide under the trade name Capoten. Captopril is the product of research and development work at the Squibb Institute for Medical Research, at the time a branch of Squibb Pharmaceuticals, now Bristol-Myers Squibb. The health of millions of people worldwide has been sustained or restored through the use of captopril and its pharmaceutical relatives. This action marked the beginning of a major change in the treatment of high blood pressure and, later, congestive heart failure, diabetic kidney damage, postheart attack management, and stroke prevention. FDA approved a molecule captopril for the treatment of elevated blood pressure, otherwise known as hypertension.
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