How Do ACE Inhibitors Work?

Angiotensin-converting enzyme (ACE) inhibitors work by primarily relaxing the blood vessels and thereby bringing down the elevated blood pressure. They are a class of medicines that are used to treat high blood pressure, heart problems, and other conditions.

ACE inhibitors act by stopping the action of an enzyme called angiotensin-converting enzyme. This enzyme converts a signal protein in the body, angiotensin I to angiotensin II. Angiotensin II is a substance that narrows the blood vessels and contributes to salt and water retention in the body, which increases blood pressure. ACE inhibitors block the action of angiotensin II and dilate the blood vessels, which in turn lowers the blood pressure.

Other effects of ACE inhibitors include breaking down of bradykinin (responsible for dilating the blood vessels). ACE inhibitors block the action of ACE and stop the breaking down of bradykinin. An increase in bradykinin levels causes widening of blood vessels and helps in decreasing the blood pressure.

ACE inhibitors are effective for:

• Controlling blood pressure
• Congestive heart failure (chronic progressive condition that affects the pumping power of your heart muscle)
• Prevention of stroke and hypertension or diabetes-related kidney damage

Common side effects of ACE inhibitors include:

• Dry cough
• Low blood pressure
• Fatigue
• Dizziness
• Headache
• Loss of taste
• Skin rash

Some rare but serious side effects may include:

• Angioedema (rapid edema or swelling of the area beneath the skin)
• Increased potassium levels in the blood (hyperkalemia)
• Renal failure in patients with bilateral renal artery stenosis
• ACE inhibitors may be harmful to both mother and the baby if taken during pregnancy
• Chest pain
• Pancreatitis (swelling of pancreas)

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

ACE inhibitors should not be taken with an angiotensin receptor blocker or with a direct renin inhibitor. The intake of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen sodium should also be limited as they decrease the effectiveness of ACE inhibitors.

ACE inhibitors work better for younger people than for older people.

It was believed that taking ACE inhibitors may pose serious illness in COVID-19 patients. However, recent observational studies did not provide any such evidence. A panel convened by the US National Institutes of Health recommends continuing ACE inhibitors if necessary for patients with COVID-19 in its treatment guidelines.

Drug Names of ACE Inhibitors Include:

• Accupril
• Aceon
• Altace
• Benazepril
• Capoten
• Captopril
• Captoril
• Enalapril
• Enalaprilat
• Epaned
• Fosinopril
• Lisinopril
• Lotensin
• Mavik
• Moexipril
• Monopril
• Perindopril
• Prinivil
• Qbrelis
• Quinapril
• Ramipril
• Trandolapril
• Univasc
• Vasotec
• Vasotec IV
• Zestril