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so an ace inhibitor has an interesting uh story behind it this is the first drug approved by the fda that came from a snakeamp;#39;s venom so brazilian pit vipers when they bite their prey the drug in their venom can cause hypotension and venous dilatation this was subsequently isolated and used to create captopril so ace inhibitors these should be used in all patients who have heart failure to reduce ejection fraction regardless of symptoms so new york heart association class to class one to four it improves more both mortality and morbidity and an ace is generally preferred and if not again you can choose an angiotensin receptor blocker
