Angiotensin-converting enzyme (ACE) inhibitors play a crucial role in managing blood pressure by relaxing veins and arteries. But how exactly does this mechanism work? ACE aids in the production of Angiotensin II, a hormone that constricts blood vessels, potentially causing high blood pressure and exerting additional pressure on the heart. ACE inhibitors disrupt this sequence by releasing enzymes that negate these effects, including bradykinin, a peptide vasodilator. Moreover, Angiotensin II can trigger other hormones that further elevate blood pressure.
When Should You Use ACE Inhibitors?
ACE inhibitors are commonly prescribed to prevent, manage, or alleviate symptoms of:
- High blood pressure (hypertension)
- Cardiovascular disease
- Heart failure
- Heart attacks
- Diabetes
- Certain chronic kidney conditions
- Scleroderma (a condition leading to the hardening of skin and connective tissues)
- Migraines
Note: ACE inhibitors can be combined with other blood pressure medications such as diuretics or calcium channel blockers. However, they should not be used with angiotensin receptor blockers or direct renin inhibitors.
Side Effects of ACE Inhibitors
Below is a list of potential side effects associated with ACE inhibitors:
- Dry cough
- Elevated blood potassium levels (hyperkalemia)
- Fatigue
- Dizziness due to low blood pressure
- Headaches
- Loss of taste
In rare cases, ACE inhibitors may cause tissue swelling. If you experience persistent throat swelling, it can be a life-threatening condition and should be treated as an emergency.
The efficacy of ACE inhibitors can be reduced by nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, among others). While occasional use of NSAIDs is generally safe, frequent use may require a discussion with your doctor regarding potential drug interactions.
Furthermore, using ACE inhibitors during pregnancy may raise the risk of birth defects. If you are pregnant or planning to become pregnant, consult your doctor for alternative high blood pressure treatments.
List of ACE Inhibitors
ACE inhibitors are widely available, and the best choice for you will depend on factors such as your overall health and existing conditions. For example, people with chronic kidney disease may benefit significantly from an ACE inhibitor.
Some commonly prescribed ACE inhibitors include:
- Benazepril (Lotensin)
- Captopril
- Enalapril (Vasotec)
- Fosinopril
- Lisinopril (Prinivil, Zestril)
- Moexipril
- Perindopril
- Quinapril (Accupril)
- Ramipril (Altace)
- Trandolapril
You can purchase ACE inhibitor medications at your local pharmacy or on BridgeHealth.com.