ACE and diabetes mellitus: The ACE inhibitors reduce the rates of death, myocardial infarction, stroke, and heart failure among patients with heart failure,103 left ventricular dysfunction,104 previous vascular disease,105 and/or high-risk diabetes.106 The ARBs are an alternative for patients who cannot tolerate ACE inhibitors Although ACE inhibitors and ARBs have an additive effect, the more effective indication is to combine ACE inhibitor therapy with an aldosterone antagonist.