What Are ACE Inhibitors?
These medicines are typically prescribed to treat and manage high blood pressure by relaxing blood vessels and lowering the amount of salt and water in the body.
Blood pressure management is important for reducing your risk of other conditions, like heart attack or stroke.
Guidelines for treating high blood pressure recommend angiotensin-converting enzyme inhibitors — commonly called ACE inhibitors — as one of the first lines of treatment for high blood pressure. The drug works by preventing an enzyme in your body from producing angiotensin II, a substance that causes blood vessels to narrow and increases blood pressure.
In addition to treating high blood pressure, this class of medication is used for several other conditions, including congestive heart failure and chronic kidney disease. “Certain patients who have had a heart attack (myocardial infarction) may also be prescribed an ACE inhibitor,” says Ashish Sarraju, MD, a preventive cardiologist at Cleveland Clinic.
ACE inhibitors are also used to prevent or treat:
“Certain ACE inhibitors are considered for patients with Raynaud's phenomenon,” Dr. Sarraju reports. Raynaud’s phenomenon is a medical condition that causes the blood vessels of the hands and feet to become too narrow for adequate blood flow.
The length of time a person is on this medication will depend on why the medication was prescribed. Sarraju says that when this medication is prescribed for medical conditions such as high blood pressure or heart failure or some types of renal disease, a person will likely be on this medication long-term. He notes that lowering the likelihood of needing this medication will somewhat depend on lifestyle factors. “To reduce the risk of high blood pressure, for instance, some preventive measures include following a proven, heart-healthy dietary pattern, exercising regularly, maintaining a normal weight, and ensuring adequate, good-quality sleep.”
Some commonly prescribed ACE inhibitors include:
Most ACE inhibitors are prescribed only in pill form, except Vasotec (enalapril), which can also be prescribed intravenously.
Side effects of ACE inhibitors include:
Some people who take these drugs develop a dry cough that makes it hard to speak. This is more common in women than in men. The cause of this side effect is unknown. The cough is usually dry and can develop within hours after the first dose for some; in others, the cough may appear months later. The ACE inhibitor cough might go away after a while, but tell your doctor if it doesn't. Your healthcare provider may want to lower your medication dose, or switch you to a different medication to resolve this side effect. The cough typically resolves within one to four weeks after you stop this medication.
Talk to your doctor if you frequently take nonsteroidal anti-inflammatory drugs (NSAIDs), since they may make an ACE inhibitor less effective. Some NSAIDs, like ibuprofen (Advil, Motrin) and naproxen sodium (Aleve), have been shown to decrease the effectiveness of ACE inhibitors.
“Caution should be used if there is preexisting severe renal disease, high potassium levels, or low blood pressure,” Sarraju says. These are also side effects of ACE inhibitors, which may worsen for people already living with these medical conditions.
If you have a history of angioedema (swelling under the skin), hereditary angioedema, or a sensitivity to ACE Inhibitors, your doctor may want to prescribe a different medication. Angioedema is more common in African Americans.
Talk to your doctor if you are pregnant or plan to become pregnant or are breastfeeding. This medication can increase the risk of birth defects.
Additional reporting by Alexandria Jones-Patten.
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