Also worth mentioning ACE inhibitors didn’t show lower risk of death in the 2024 UK Biobank data and actually showed a (slightly) faster risk. I see no reason for anyone to use an ACEi over an ARB.
“As our findings suggested that there may be a drug class effect on mortality, we performed a pooled analysis, combining drugs from the same class (Methods). We selected Statins, PDE5i, Estrogens, given that we observed some positive effect on survival for some of these drugs. We added SGLTi, and Metformin, due to previous reports of positive effect, and ACEi due to potential reports of positive effects (Figure 5, Data Table 5). Statins (HR 0.97, Cl 0.94-1.00) and Estrogen (HR 0.76, Cl 0.67-0.85), as a class, reduced mortality, so did SGLT2i (HR 0.64, Cl 0.45-0.89), although with a much lower sample size. Metformin (HR 1.01, Cl 0.95-1.07) had a neutral effect on mortality, while ACEi (HR 1.11, Cl 1.06-1.15) was associated with increased mortality.”