Hypertension, commonly known as high blood pressure, is a serious condition that affects one of every three adults in the United States. It’s characterized by a blood pressure reading above 140/90 mmHg.
In people with hypertension, blood moves through the blood vessels at a higher pressure. This puts increased pressure on the delicate tissues and damages the vessels. People who have hypertension are often prescribed medication by a healthcare professional to help manage their condition. Medications that lower blood pressure are called antihypertensives and come in a variety of classes. ACE inhibitors are one class of antihypertensives.
ACE stands for angiotensin-converting enzyme. These medications lower blood pressure by encouraging the blood vessels to relax and open. This promotes the free flow of blood.
Since 1981, ACE inhibitors have been commonly prescribed to treat hypertension. This is because they tend to be well-tolerated by those who take them. They’re usually taken just once a day, often in the morning. They may be prescribed along with diuretics or calcium channel blockers, which are also used to treat high blood pressure.
How ACE Inhibitors Work
ACE inhibitors have two primary functions. First, they decrease the amount of sodium retained in the kidneys. Secondly, they stop the production of a hormone called angiotensin II. This hormone usually causes blood vessels to narrow. When this hormone isn’t produced, blood flows through the vessels more effectively. This helps the blood vessels to relax and expand, which lowers blood pressure.
For a better visual, imagine a garden hose. It would take longer and require more pressure to obtain a gallon of water through a hose with a quarter-inch diameter than it would to obtain it through a garden hose with a one-inch diameter. Less pressure would cause the water to dribble out of the hose. More pressure would make the water flow out easily.
Types of ACE Inhibitors
Common ACE inhibitors include:
- benazepril (Lotensin)
- captopril (Capoten)
- enalapril (Vasotec)
- fosinopril (Monopril)
- lisinopril (Zestril)
- quinapril (Accupril)
- ramipril (Altace)
- moexipril (Univasc)
- perindopril (Aceon)
- trandolapril (Mavik)
Benefits of ACE Inhibitors
Aside from lowering blood pressure, ACE inhibitors may also have a positive impact on overall health. These medications can slow the progression of kidney disease and atherosclerosis. Atherosclerosis is a narrowing of the arteries caused by a buildup of plaque. ACE inhibitors have also been proven beneficial for those with diabetes.
Side Effects of ACE Inhibitors
Most people tolerate these medications well. Like all medications, however, ACE inhibitors can cause a number of side effects in some people. These include:
- decreased ability to taste
- a dry, hacking cough
- low blood pressure
In rare cases, ACE inhibitors may cause the lips, tongue, and throat to swell, making it difficult to breathe. This is more likely to happen in people who smoke. Smokers should speak with their doctor about their risk before using an ACE inhibitor.
People with impaired kidney function should also use caution when taking this type of medication. An ACE inhibitor can cause an increase in potassium levels. This may lead to kidney failure in those with damaged kidneys.
Due to the risk of these side effects, ACE inhibitors usually aren’t recommended for pregnant women.
Some over-the-counter pain medications may decrease the effectiveness of ACE inhibitors. Make sure to check with your doctor before taking ibuprofen (Advil), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs. Taking these pain medications occasionally while taking a prescribed ACE inhibitor probably isn’t harmful. But you should avoid using them regularly. Speak with your doctor or pharmacist if you have any concerns about potential drug interactions.
Taking Your Medication
As with any prescribed medication, you should never stop taking an ACE inhibitor unless your doctor tells you to do so. It may be tempting to toss your pills once you’re feeling better. But taking them consistently will help keep your blood pressure in a healthy range. If you’re experiencing side effects, call your doctor before you stop taking the medication. Your side effects may diminish over time. Your doctor may also have special instructions on how to discontinue the medication.
ACE inhibitors can be an important tool in maintaining normal blood pressure and a healthy heart. The key is taking your medication as prescribed and being mindful of potential interactions.
You asked, we answered
- How do ACE inhibitors compare to other types of medications used to treat hypertension?
ACE inhibitors cause your blood vessels to relax and reduce the pressure your heart has to push against. Other medications used to treat hypertension include beta-blockers and diuretics. Beta-blockers slow the heartbeat and lower the stress on the heart. Diuretics make your kidneys release more water. This reduces how much volume your heart has to pump.- Alan Carter, PharmD