The heart is a tireless pump that supplies all tissues and organs with oxygen and blood through the vascular system. For it to work smoothly the heart must be put first in line for proper nutrient and oxygen supply. As a result, every illness of the heart or coronary arteries that feed the heart, will lead to serious health consequences. Because of this, many medications are used for the treatment and prevention of further cardiovascular complications. One of them is a drug called perindopril, which belongs to the group of ACE inhibitors. It is one of the most commonly prescribed drugs. It is mainly used to treat high blood pressure, symptomatic heart failure and to reduce the risk of cardiovascular events in stable coronary artery diseases.

The mechanism of perindopril activity

The hormone renin-angiotensin-aldosterone system (RAAS) regulates blood pressure and electrolyte balance in our body. Renin breaks angiotensin down into angiotensin I, which is then converted to angiotensin II through the angiotensin converting enzyme (ACE). The latter stimulates the secretion of the hormone aldosterone, which causes sodium reabsorption in the kidneys, thereby increasing the volume of fluid in the body and consequently increasing blood pressure. 

Several medications in the RAAS system are used for lowering blood pressure. One of these, perindopril, inhibits the ACE enzyme activity. Perindopril helps lower the level of angiotensin II in plasma, leading to an increased plasma renin activity (by blocking the negative feedback of renin release) and reduced secretion of aldosterone. Perindopril can lower the blood pressure directly or with the help of some other mechanisms and it can prevent worsening of coronary heart disease and other vascular events. Studies have shown that there is a colleration between the AT1 (the gene for the angiotensin II receptor, subtype 1) and BK1 (bradykinin receptor gene, subtype 1) genes and the effectiveness of perindopril in stable coronary artery disease.