What is the primary function of ACE inhibitors in patients with angina?

The primary function of ACE inhibitors in patients with angina is to reduce afterload and improve hemodynamics. This action is significant because angina is often caused by inadequate blood flow to the heart muscle, typically due to coronary artery disease. By inhibiting the angiotensin-converting enzyme (ACE), these medications help to lower levels of angiotensin II, a potent vasoconstrictor, leading to vasodilation of both systemic and pulmonary blood vessels.

As a result, there is a decrease in vascular resistance (afterload), which reduces the workload on the heart. This is beneficial in managing angina because when the heart has to work less against resistance, it can better maintain oxygen supply to the myocardium, ultimately alleviating the symptoms of angina.

In contrast, while increasing heart rate or enhancing cholesterol metabolism might affect cardiovascular health, they do not directly address the mechanisms involved in angina management as ACE inhibitors do. Similarly, inducing vasodilation without affecting blood pressure does not capture the full scope of how ACE inhibitors function in providing relief in anginal scenarios. The primary goal in the use of ACE inhibitors is effectively related to reducing afterload and improving overall heart function in the context of angina.