Angiotensin-converting enzyme inhibitor

Angiotensin-Converting Enzyme Inhibitor

Angiotensin-converting enzyme inhibitors, commonly referred to as ACE inhibitors, are a class of medication used primarily for the treatment of hypertension and congestive heart failure. They work by inhibiting the activity of the enzyme angiotensin-converting enzyme (ACE), which is responsible for the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.

Mechanism of Action

ACE inhibitors block the conversion of angiotensin I to angiotensin II. Angiotensin II is a peptide hormone that causes blood vessels to constrict, resulting in increased blood pressure. By inhibiting this conversion, ACE inhibitors cause vasodilation, which leads to a decrease in blood pressure. Additionally, they reduce the secretion of aldosterone, which decreases sodium and water retention, further lowering blood pressure.

Clinical Uses

ACE inhibitors are used in the management of several cardiovascular and renal conditions, including:

• Hypertension: They are often prescribed as first-line therapy for high blood pressure.
• Heart Failure: ACE inhibitors help reduce the workload on the heart by lowering blood pressure and decreasing fluid retention.
• Chronic Kidney Disease: They are beneficial in slowing the progression of kidney disease, particularly in patients with diabetes.
• Post-Myocardial Infarction: They can improve survival rates and reduce the risk of subsequent heart attacks.

Common ACE Inhibitors

Some commonly prescribed ACE inhibitors include:

• Captopril
• Enalapril
• Lisinopril
• Ramipril
• Benazepril

Side Effects

While ACE inhibitors are generally well-tolerated, they can cause side effects in some patients. Common side effects include:

• Cough: A persistent dry cough is a well-known side effect.
• Hyperkalemia: Elevated potassium levels can occur, especially in patients with renal impairment.
• Angioedema: Swelling of the deeper layers of the skin, often around the eyes and lips, can occur and may be life-threatening.
• Hypotension: Excessive lowering of blood pressure can lead to dizziness and fainting.

Contraindications

ACE inhibitors are contraindicated in certain conditions, such as:

• Pregnancy: They can cause fetal harm when administered to a pregnant woman.
• Bilateral Renal Artery Stenosis: They can worsen renal function in these patients.
• History of Angioedema: Patients with a history of angioedema related to previous ACE inhibitor use should avoid them.

Also see

• Angiotensin II receptor blocker
• Hypertension
• Heart failure
• Renin-angiotensin system

Cardiovascular disease A-Z

Most common cardiac diseases

• Cardiac arrhythmia‎
• Cardiogenetic disorders‎
• Cardiomegaly‎
• Cardiomyopathy‎
• Cardiopulmonary resuscitation‎
• Chronic rheumatic heart diseases‎
• Congenital heart defects‎
• Heart neoplasia‎
• Ischemic heart diseases‎
• Pericardial disorders
• Syndromes affecting the heart‎
• Valvular heart disease‎

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

• Accelerated idioventricular rhythm
• Acute decompensated heart failure
• Arteriosclerotic heart disease
• Athletic heart syndrome
• Atrial flutter
• Atrioventricular fistula
• Cardiovascular disease in Australia
• Autoimmune heart disease

B

• Brown atrophy of the heart

C

• Ebb Cade
• Cardiac allograft vasculopathy
• Cardiac amyloidosis
• Cardiac asthma
• Cardiac tamponade
• Cardiogenic shock
• Cardiogeriatrics
• Cardiorenal syndrome
• Cardiotoxicity
• Carditis
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• Cœur en sabot
• Coxsackievirus-induced cardiomyopathy

D

• Duke Treadmill Score
• Duroziez's disease

E

• Eisenmenger's syndrome
• Embryocardia
• Endocardial fibroelastosis
• Eosinophilic myocarditis

H

• Heart attack
• Heart failure
• Heart failure with preserved ejection fraction
• Heart to Heart (1949 film)
• High-output heart failure
• Hyperdynamic precordium

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

I

• Idiopathic giant-cell myocarditis
• Interventricular dyssynchrony
• Intraventricular dyssynchrony
• Isolated atrial amyloidosis

K

• Keshan disease

L

• Loeffler endocarditis

M

• Mydicar
• Myocardial bridge
• Myocardial disarray
• Myocardial rupture
• Myocardial scarring
• Myocardial stunning
• Myocarditis

N

• Nonbacterial thrombotic endocarditis

O

• OLR1
• Ostial disease

P

• Papillary fibroelastoma
• Pathophysiology of heart failure
• Postpericardiotomy syndrome
• Pulmonary vein stenosis

R

• Right axis deviation
• Roemheld syndrome

S

• Saturated fat and cardiovascular disease
• SCAR-Fc
• Shone's syndrome
• Strain pattern
• Subacute bacterial endocarditis
• Sudden cardiac death of athletes

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

T

• Traumatic cardiac arrest

V

• Ventricular aneurysm
• Vibroacoustic disease
• Viral cardiomyopathy

W

• Waon therapy