ACE Inhibitors

ACE inhibitors such as Captopril, Enalapril, Ramipril, and the like are also among the first-line hypertension medications in the treatment of hypertension. They are used either alone (as monotherapy) or preferably in combination with other blood pressure medications (as combination therapy). ACE inhibitors can slow the progression of chronic heart failure and have life-prolonging effects. This is believed to be due to the reduction of the heart's afterload caused by ACE inhibitor therapy. ACE inhibitors are also used after heart attacks or myocarditis, as they prevent the conversion of damaged heart muscle cells into connective tissue.

What do ACE inhibitors inhibit?

ACE inhibitors inhibit a specific enzyme (angiotensin-converting enzyme) and thus interfere with a chain of protein transformations. The inhibition leads to less angiotensin II being formed, which normally causes contraction (tension) of the vascular musculature and increases the secretion of aldosterone. Due to the subsequent dilation of the vessels and increased fluid excretion, there is a reduction in blood pressure. However, the breakdown of a hormone is also inhibited, leading to increased bradykinin in the body, which is partly responsible for the sometimes occurring unpleasant dry cough during ACE inhibitor therapy.
Unlike beta-blockers or calcium antagonists, ACE inhibitors do not interfere with the heart's conduction system and thus have no effect on heart rate.

ACE Inhibitors: Side Effects

Since bradykinin acts similarly to histamine, it can lead to a range of side effects such as edema (the feared angioedema, which causes swelling of the skin and mucous membranes, especially in the face and neck area) and a persistent dry cough. This dry cough, which is completely harmless but can be very bothersome, may also occur only after prolonged therapy and often leads to discontinuation of the medication.

Since the lower aldosterone level increases potassium uptake, elevated potassium levels may also occur. This must be particularly considered in patients with impaired kidney function and simultaneous intake of certain other medications.
ACE inhibitors can damage the liver and, in very rare cases, lead to acute liver failure.

It is not uncommon for complaints such as dizziness due to rapid blood pressure drop to occur at the beginning of treatment. Gastrointestinal complaints, headaches, taste disturbances, muscle complaints, and various other general symptoms may also occur sporadically.
For a complete list of all possible side effects, please also read the manufacturer's information in the package insert of your medication.
The doctor must also always pay attention to possible interactions when taking other medications.

ACE Inhibitors: Active Ingredients

Benazepril, Captopril, Cilazapril, Enalapril, Fosinopril, Lisinopril, Moexipril, Perindopril, Quinapril, Ramipril, Trandolapril

ACE Inhibitors: Active Ingredients and Approved Medicinal Substances

Sources:

By Sabine Croci. This article is medically reviewed. Last updated (03/2024).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.

We hope you found the article on the topic helpful. For good blood pressure management, it is important to take the medications correctly. Our app BloodPressureDB is happy to remind you of the intake times. It also manages the supply and informs you in good time when it is running low. This feature is also fully available in the free version. Get the free app now.

Our offering meets the afgis transparency criteria. The afgis logo stands for high-quality health information on the internet.