We use blood pressure–lowering agents as the cornerstone of management to prevent vascular complications and kidney failure in people with chronic kidney disease (CKD), although most available drugs (such as calcium channel blockers, β-blockers, and diuretics) have been poorly studied. The notable exception is angiotensin-converting enzyme (ACE) inhibitors: landmark trials in the early 1990s provided strong evidence that these agents delay progression to kidney failure among people with CKD, in particular in those with diabetic kidney disease, driving widespread use.