Angiotensin converting enzyme inhibitors, or ACE inhibitors, are a class of
oral medications that act primarily through blockade of the angiotensin
converting enzyme. This enzyme converts angiotensin I to
angiotensin II. Angiotensin II causes vasoconstriction that increases
afterload, thus increasing systemic blood pressure. Angiotensin
contributes to the production of aldosterone, which normally acts to
retain sodium and water.
- A non-productive cough is common with ACE inhibitors and is due to increased bradykinin in the lungs. This cough does not occur with angiotensin receptor blockers (ARBs).
Angioedema is a life-threatening reaction that is relatively common with ACE inhibitors.
A rash is common with ACE inhibitors.
Hypotension can occur with ACE inhibitors, causing dizziness and weakness.
Hyperkalemia can occur due to the aldosterone inhibition.
Renal failure can occur due to efferent arteriolar vasodilation.