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Why are the angiotensin converting enzyme inhibitors rational in the treatment of congestive heart failure?

In chronic congestive heart failure, there is stimulation of the renin-angiotensin-aldosterone system, in addition to other homeostatic mechanisms. In addition to increased tone in the arteriolar and venous beds, there is salt and water retention by the kidney and excitation of the central nervous system by angiotensin. Interference with the generation of angiotensin reduces preload and afterload without a reflex tachycardia as the effects of angiotensin on the central nervous system are reduced. ACE inhibition is, therefore, a logical approach to the management of chronic congestive heart failure.