ACE inhibitors, ACE-I

Angiotensin converting enzyme inhibitors (ACE-I) are commonly used to treat hypertension as they relax the blood vessels and lower the blood pressure by blocking the activity of angiotensin-II converting enzyme. In this way, ACE inhibitors decrease workload on the heart and help improve blood flow to body organs. ACE inhibitors are also indicated in treatment of heart failure, particularly in combination with beta-blockers and aldosterone antagonists.

Ramipril, Lisinopril and Enalapril are the most commonly used ACE inhibitors in the UK.

While using ACE inhibitors you need to monitor your blood pressure regularly. Also, your GP will check your kidney function by taking a blood sample about 7-10 days after starting the treatment and following each subsequent adjustment in dose. ACE inhibitors may exacerbate kidney problems in about 1 out of 10 patients.

As with any other medication, ACE inhibitors should not be stopped without your physician’s advice. Sudden withdrawal of ACE inhibitors may lead to dangerous increase in blood pressure.

Dry cough is the most common side effect of ACE inhibitors and in some people may necessitate change to angiotensin receptor blockers (ARBs) which have a very similar mode of action but without this particular side effect. Some people may experience dizziness or even fainting due to excessive drop in blood pressure (hypotension), in which case ACE inhibitor should be taken at bed time.