The level of inactivity could explain the discrepancy between the present data and the effect of ACE inhibitors in relatively healthy populations being treated for hypertension.17 There is also evidence that an exercise stimulus may be needed for ACE inhibition to promote adaptive changes, such as an increase in capillary density, in skeletal muscle.25 Therefore, the current data do not preclude the possibility that the use of ACE inhibition in the context of pulmonary rehabilitation may yield benefit. The gene discussed is ACE; the disease is hypertensive disorder.