ACE inhibitors and Angiotensin Receptor Blockers (ARBs) may be preferred in patients with atherosclerotic cardiovascular disease (ASCVD) or an increased aortic diameter.

“so for example there was the hope trial right which was um I think you know mid 2000s and so it suggested there may be a benefit in people with atherosclerotic coronary disease to have to have an A inhibitor on board — so maybe in people with with uh you know with asbd or acbd risk I'll use that one over the others as a first line it's also you know there's the whole ARB and and aortic diameter thing right so people who may have a little of you know increase whether you want to call it an aneurysm but just an increase in in ax size that there may be a benefit to arbs”