Overview
Angiotensin converting enzyme (ACE) inhibitors belong to a class of medicines called antihypertensives, which are used to treat high blood pressure (hypertension). Their primary function is to widen the blood vessels of the body to improve blood flow and heart function.
Detailed Description
High blood pressure increases the work demand from the heart and puts substantial strain on the arteries. If high blood pressure persists for a sustained amount of time, the heart and arteries may not function properly. This strain can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attack.
Some inhibitors, such as lisinopril, captopril, ramipril, and trandolapril, are used in a number of patients after a heart attack. Lisinopril use may be started within 24 hours after a heart attack to increase survival rate. Captopril, ramipril, and trandolapril can help slow down the further weakening of the heart. Captopril is also used to treat kidney problems in some diabetic patients who use insulin to control their diabetes. In addition, some ACE inhibitors are used to treat congestive heart failure or may be used for other conditions as determined by one’s doctor.
Side Effects and Risks
ACE inhibitors are potent medicines that treat but do not cure chronic conditions such as high blood pressure. The FDA advocates that patients who are prescribed ACE inhibitors take the medication regularly and in the correct dosages. Taking doses at the same time each day can help one remember to take the drug regularly.
Fatigue, dizziness, headache, insomnia, nausea, vomiting, and diarrhea are all common side effects. These side effects are usually mild. The risk for losing one’s sense of taste is possible, especially with the drug captopril. Taste usually returns within two to three months, even when one is still on the medication. Some people develop a persistent dry cough while taking ACE inhibitors. The cough usually persists during the course of the prescription. Bothersome coughs should be discussed with a doctor. ACE inhibitors can cause dizziness, lightheadedness, or even fainting, usually during the first few days. A mild, sometimes itchy, skin rash can occur and may be accompanied by fever or joint pains. This side effect usually appears within the first four weeks of beginning an ACE inhibitor, especially captopril. More serious but infrequent reactions that sometimes occur with ACE inhibitors include fever and chills.
Effectiveness
ACE inhibitors have been found to prolong the lives of patients suffering from chronic heart failure. Many medical studies over the last 20 years show that ACE inhibitors reduce the risk of death by 20 to 40%. In a study that combined four large-scale drug trials in Australia, Canada, China, Europe, the Mediterranean, Scandinavia, South Africa, and South America, people receiving ACE inhibitors were compared to the control group. ACE inhibitors were given within 36 hours of heart attack symptoms, and treatment continued for up to six weeks. After 30 days, the death rate from heart attack was reduced by 7% in the treatment group.
Last updated: 31-May-04
