Cardiovascular disease (CVD) is a significant global health concern shaped by genetic, environmental, and lifestyle factors. The ACE gene, particularly its I/D polymorphism, impacts ACE activity and the RAAS system. This gene influences blood pressure, fluid balance, and vascular function by modulating angiotensin II levels, a crucial peptide in cardiovascular regulation and disease. This review explores the physiological implications of ACE gene polymorphisms, focusing on how they influence cardiovascular risk through modulation of RAAS activity. By examining the genetic basis and functional outcomes of these polymorphisms, this review aims to shed light on their contribution to CVD development and progression, highlighting potential avenues for targeted therapies and risk management strategies