ACE and Stroke: In the early 2000s, two large-randomized clinical trials, the Heart Outcomes Prevention Evaluation (HOPE) trial1 and the European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease2, showed that in patients with risk of cardiovascular disease (CVD) but without heart failure, angiotensin converting enzyme inhibitors (ACE inhibitors) resulted in a relative risk (RR) reduction of about 20% in mortality, MI, and stroke in 4–5 years follow-up.