The ACE inhibitors are one of the few classes of agents for which there is any reasonable evidence of an effect on cardiac remodelling. Yet, even with this class of drugs, researchers know little about how this effect is achieved. At the 6th International Symposium on Cardiovascular Pharmacotherapy [Sydney, Australia; February 1996], leading cardiologists looked at the possible mechanisms behind left ventricular hypertrophy (LVH) and its reversal. This largely concentrated on the ACE inhibitors, although preliminary views on the potential of angiotensin II antagonists were also aired.