ACE inhibitors

Wirkungsweise Bluthochdruck Medikament ACE-Hemmer

ACE inhibitors such as Captopril, Enalapril, Ramipril and others are also first-line medications for treating high blood pressure. They are used either alone (as monotherapy) or preferably together with other blood pressure medicines (as combination therapy). In chronic heart failure they can slow the worsening of the condition and can prolong life. This is thought to be due to the lowering of the heart's afterload that occurs with ACE inhibitor therapy. ACE inhibitors are also used after heart attacks or myocarditis; among other things, they prevent damaged heart muscle cells from being replaced by scar tissue.

What do ACE inhibitors block?

ACE inhibitors block a specific enzyme (angiotensin-converting enzyme) and thus interrupt a chain of protein transformations. By blocking the enzyme, less angiotensin II is formed; angiotensin II normally causes the muscles in the blood vessel walls to contract and stimulates the release of aldosterone. Because the blood vessels then widen and more fluid is expelled from the body, blood pressure is reduced. However, the breakdown of a hormone is also inhibited, which leads to increased levels of bradykinin in the body this is one reason for the sometimes bothersome dry cough seen with ACE inhibitor therapy.
Unlike drugs such as beta-blockers or calcium channel blockers, ACE inhibitors do not affect the heart's electrical conduction and therefore do not change the heart rate.

ACE inhibitors: side effects

Because bradykinin acts similarly to histamine, it can cause several side effects such as fluid buildup (edema) the feared angioedema can cause swelling of the skin and mucous membranes, especially in the face and neck and a persistent dry cough. This dry cough is harmless but can be very annoying; it may occur only after longer treatment and often leads to stopping the medication.

Because the lower aldosterone level increases potassium retention, potassium levels can also rise. This must be considered especially in patients with reduced kidney function and in those taking certain other medications at the same time.
ACE inhibitors can damage the liver and in very rare cases cause acute liver failure.

It's not uncommon at the start of treatment to experience symptoms such as dizziness from the rapid drop in blood pressure. Gastrointestinal complaints, headaches, changes in taste, muscle complaints and various other general symptoms can also occur occasionally.
For a complete list of all possible side effects, please also read the manufacturer's information in the leaflet that comes with your medicine.
Your doctor must also always be aware of possible interactions with other medicines.

ACE inhibitors: active substances

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

ACE inhibitors: active substances and approved medicines

Wirkstoff	Produkte
Benazepril	Benazeplus Kombipräparat, Benazepril, Cibacen, Cibadrex Kombipräparat
Captopril	ACE-Hemmer-Ratiopharm, Capto comp Kombipräparat, Capto-CT, Captobeta, Captogamma, CaptoHEXAL Kombipräparat, Captopril Kombipräparat, Tensobon
Cilazapril	Dynorm
Enalapril	Benalapril, Carmen Kombipräparat, Corvo, Ena-Lerca Kombipräparat, Enabeta Kombipräparat, EnaCanpin Kombipräparat, EnaHEXAL, Enala-Q comp Kombipräparat, Enalagamma Kombipräparat, Enalapril, Enaplus Kombipräparat, Eneas Kombipräparat, Jutaxan, Lercaprel Kombipräparat, Renacor Kombipräparat, Xanef, Zaneril Kombipräparat, Zanipress Kombipräparat
Fosinopril	Dynacil, Fosino-Teva, Fosinopril, Fosinorm
Lisinopril	Acercomp Kombipräparat, Lisi Lich, Lisi TAD HCT Kombipräparat, Lisibeta, Lisigamma, LisiHEXAL, Lisinopril, Lisiplus Kombipräparat
Moexipril	Fempress plus Kombipräparat
Perindopril	Bipreterax Kombipräparat, Coversum, Perindopril Kombipräparat, Preterax Kombipräparat, Rindecombi Kombipräparat, Stapressial Kombipräparat, Triveram Kombipräparat, Viacoram Kombipräparat
Quinapril	Accupro, Accuzide Kombipräparat, Quinaplus Kombipräparat, Quinapril
Ramipril	Arelix Kombipräparat, Delix Kombipräparat, Delmuno Kombipräparat, Iltria Kombipräparat, Rami-Q, Ramiclair Kombipräparat, RamiDipin Kombipräparat, RamiGamma, RamiLich, Ramiplus Kombipräparat, Ramipril Kombipräparat, Ramitanid Kombipräparat, Sincronium, Tonotec Kombipräparat, Triapin Kombipräparat
Trandolapril	Tarka Kombipräparat, Udrik
Zofenopril	Zofenil

Sources:

This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 03/2024).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.

We hope you found the article helpful. For good blood pressure control, it's important to take your medications correctly. Our app BloodPressureDB will gladly remind you when to take them. It also keeps track of your medication supply and notifies you in time when you're running low. This feature is fully available in the free version as well. Get the free app now.