ACE and diabetes mellitus: In addition, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) should be prioritized, especially in patients with hypertension, diabetes, or impaired ventricular function, as these agents have shown endothelial benefits and may mitigate shear-stress-induced endothelial injury, which plays a role in erosion pathogenesis [55].