ACE and metabolic syndrome: The mean age was 81 ± 7 years; the majority of patients had hypertension (76%), dyslipidemia (60%), presented with New York Heart Association (NYHA) class III-IV heart failure symptoms (62%), and used cardiovascular medications including angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (56%), beta blockers (59%), diuretics (58%), and statins (56%).