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Ramipril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure (hypertension), heart failure, and to improve survival after a heart attack. It is also prescribed to reduce the risk of heart attack, stroke, and cardiovascular death in patients at high risk for these events. Ramipril acts as a prodrug that is converted in the body to its active form, ramiprilat. The primary mechanism of action involves inhibition of ACE, which prevents the conversion of angiotensin I to angiotensin II—a potent vasoconstrictor—thereby relaxing blood vessels and lowering blood pressure. Additionally, by inhibiting ACE (also known as kininase II), ramipril increases bradykinin levels leading to further vasodilation[1][2][3][4][5][6].
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