Genetically determined high ACE activity (marked by the ACE D rather than I allele) is associated with the development of metabolic syndrome (hypertension, diabetes and abnormal blood lipid profile) 17, whilst reducing RAS activity (by the use ACEIs or ARBs) also reduces the risk of people developing diabetes 18, or of them suffering a myocardial infarction (heart attack), clinical signs or symptoms of heart failure, stroke or death from a cardiovascular cause 19. This evidence concerns the gene ACE and heart failure.