Angiotensin-converting enzymes and drug discovery in cardiovascular diseases

Angiotensin-converting enzyme (ACE) is a major target in the treatment of cardiovascular diseases (CVDs). In addition to ACE, ACE2 – which is a homolog of ACE and promotes the degradation of angiotensin II (Ang II) to Ang (1–7) – has been recognized recently as a potential therapeutic target in the management of CVDs. This article reviews different metabolic pathways of ACE and ACE2 (Ang I–Ang II–AT1 receptors and Ang I–Ang (1–7)–Mas receptors) in the regulation of cardiovascular function and their potential in new drug development in the therapy of CVDs. In addition, recent progress in the study of angiotensin and ACE in fetal origins of CVD, which might present an interesting field in perinatal medicine and preventive medicine, is briefly summarized.