Routledge et al. have addressed an increasingly topical issue. They demonstrate in a small cohort of patients with aortic stenosis (AS) that the use of angiotensin- converting enzyme (ACE) inhibitors may be safe, particularly with some degree of systemic hypertension.1 This adds to the evidence that the use of ACE inhibitors in this patient population should not be strictly contraindicated. However, the more searching question of whether they should be used remains unanswered.
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