Enalapril, after hydrolysis to enalaprilat, blocks angiotensin converting enzyme (ACE) in humans. ACE is a peptidyldipeptidase that inhibits the convertion of angiotensin I to angiotensin II, which is a powerful vasoconstrictor substance that stimulates the secretion of aldosterone by the adrenal cortex. The benefits of the effects of enalapril in hypertension and heart failure, are thought to be primarily due to the inhibition of the renin-angiotensin-aldosterone system.
Enalapril is used in:
• essential and renovascular hypertension;
• congestive heart failure;
• prevention of symptomatic heart failure in patients with asymptomatic left ventricular dysfunction.