Clinical efficacy of perindopril has been proved
by using extensive clinical randomized studies in patients
with hypertension, diabetes, cerebrovascular disease, stable
coronary heart disease (CHD) and heart failure. Therefore, this
ACE inhibitor has found its place in the leading clinical guidelines
for the treatment of cardiovascular diseases. The cardioprotective
effect of perindopril is independent of its antihypertensive
effect with a positive safety profile. This is explained by
its pharmacologic properties: long half-life, high lypophility
and a high affinity for tissue ACE. ACE inhibition by perindopril
causes two main factors: prevention of creation of angiotensin
II and increase in bradykinin level. In that way, perindopril
does not only lower the high blood pressure (BP), but it is
also cardioprotective considering its antiatherosclerotic, antiinflammatory
and antithrombotic effect. The use of perindopril
in daily clinical practice needs to be based not only on antihypertensive
effect, but also on the evaluation of total cardiovascular
risk that is very high in patients with CHD, diabetes and
cerebrovascular disease
