Back in 1986, before ACE inhibitors were introduced in heart failure, we performed studies on the potential effects of ACE inhibition in heart failure. Initially, ischemia-reperfusion rat-models were used to demonstrate that ACE inhibitors prevent left ventricular remodelling after an acute myocardial infarction. Based on the positive results from these experimental studies, we decided to conduct a randomized clinical phase II trial on the effects of early intervention with ACE inhibitors during thrombolytic therapy in 298 acute myocardial infarction patients in the early 1990s. Second, we established potential anti-atherosclerotic effects of ACE inhibitors in patients with cardiovascular disease. This resulted in two randomized clinical trials on the effects of ACE inhibitors on cardiovascular events in patients undergoing coronary bypass surgery. Third, we explored the effects of ACE inhibitors on albuminuria in animal models. Once again, this resulted in a randomized controlled trial on the effects of fosinopril on cardiovascular events in 864 subjects with microalbuminuria. These and other studies have resulted in the widespread use of ACE inhibitors in cardiovascular disease.