Effect of ACE-Inhibition on Microvascular Function in Women With Assessed Microvascular Dysfunction

Inclusion Criteria: * Patients from an established cohort of patients with non obstructive coronary artery disease * Microvascular dysfunction defined as a transthoracic echocardiography measured coronary flow reserve (CFR) \< 2.2 * A good quality (quality index \> 3) examination * A blood pressure ≤ 150 at last visit in iPower * Patients who are not in treatment for documented hypertension Exclusion Criteria: * Current treatment with ACE-inhibitors or Angiotensin II-antagonists * Atrial fibrillation * Pace-maker * Allergy towards Ace-inhibitor, Ramipril ® or tool-medicine: Dipyridamole/adenosine, Nitro-glycerine or rescue medicine: Theophylline * Baseline CFR \>2.5 when entering ACIM-study. * No episodes of chest pain within 6 months before inclusion * Coronary angiography with significant stenotic lesions (\>/=50%) * Other cause of chest discomfort deemed highly likely * Left ventricular ejection fraction below 45% assessed by echocardiography at baseline measurement * Significant valvular heart disease (Definition: Verified in medical records after echocardiography. If the echocardiographer in this study suspects valvular heart disease, the patient is referred for expert evaluation and excluded from the study until valvular disease has been excluded. All definitions are taken from the guidelines of the Danish Society of Cardiology (DCS). * Haemodynamic significant Aortic Stenosis: Valve area \< 1 cm2 or \<0.6 cm2/m2 body surface area. * Severe aorta Regurgitation (…