Cardiovascular drugs angiotensin-converting enzyme inhibitors

Losartan blocks the vascular constrictor effect of Ang II, the Ang Il-induced aldosterone synthesis and/or release, and the All-induced cardiovascular growth. In various models of experimental hypertension, losartan prevents or reverses the elevated blood pressure and the associated cardiovascular hypertrophy similar to angiotensin converting enzyme (ACE) inhibitors. Subsequently con-tolled clinical trials revealed that losartan is a new and valuable drug for treatment of hyper-... 

Several standard drug therapies can markedly improve survival from cardiovascular disease in select patient populations. These include j8-blockers (77-79), aspirin (80,81), angiotensin converting enzyme (ACE) inhibitors (82,83), angiotensin receptor blockers (ARBs) (84-86), anticoagulants (including warfarin and aspirin) (87-90), aldosterone antagonists (91), and HMG-CoA reductase inhibitors (78-80,83,86,92-98). 

In a recent example, linear selective hydroformylation was employed in a large-scale synthesis of (5)-allysine ethylene acetal, reported by Chirotech. (5)-Allysine ethylene acetal is a key intermediate for several angiotensin-I converting enzyme (ACE) and neutral endopeptidase (NEP) inhibitors (for example, omapatrilat) that are currently in chnical trials (Scheme 14.3.). The inhibition of both these (ACE and NEP) enzymes by a single drug is an approach used for the treatment of cardiovascular diseases such as hypertension and heart failure. The product produced in Scheme 14.3 is also a possible precursor for (3-lactam antibiotics. ... 

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