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Angiotensin-Converting Enzyme (ACE) Inhibitors for High Blood Pressure

Examples

Generic Name Brand Name
benazepril Lotensin
captopril Capoten
enalapril Vasotec
fosinopril Monopril
lisinopril Prinivil, Zestril
perindopril Aceon
quinapril Accupril
ramipril Altace
trandolapril Mavik

How It Works

Angiotensin-converting enzyme (ACE) inhibitors block an enzyme needed to form a substance that narrows blood vessels. As a result, blood vessels relax and widen, making it easier for blood to flow through the vessels, which reduces blood pressure. These medicines also increase the release of water and sodium to the urine, which also lowers blood pressure.

ACE inhibitors can be used alone or in combination with a diuretic or other medicines.

Why It Is Used

These medicines are used alone for high blood pressure or they are used with other medicines such as a diuretic.

  • ACE inhibitors are a good choice for people who have had a heart attack, because the medicine helps reduce the workload on the heart.
  • ACE inhibitors are a good choice for people who have diabetes, because this medicine does not affect blood sugar levels and may help protect the kidneys. If you have diabetes, you may take these medicines if you do not have high blood pressure but have small amounts of protein in your urine (microalbuminuria), an early sign of kidney damage.
  • ACE inhibitors may be a good choice for people who have asthma or disorders of the electrical system of the heart that would be made worse by other blood pressure medicines such as beta-blockers.
  • ACE inhibitors may also help to prevent stroke.

How Well It Works

ACE inhibitors can reduce blood pressure in people who have high blood pressure.1

They also help people who have heart failure to live longer. And they may slow or prevent kidney problems in people who have diabetes.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Irregular heartbeats (this could be caused by too much potassium in your blood).
  • Dizziness or lightheadedness or fainting.

Common side effects of this medicine include:

  • Dry cough.
  • Headache.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

ACE inhibitor cough

A cough is one of the most common side effects of ACE inhibitors. But most people do not get a cough. The cough tends to be a minor problem for most people who have it. They feel that they can live with it in exchange for the benefits of this medicine.

If you take an ACE inhibitor and have a problem with coughing, talk with your doctor. Your cough may be caused by something else, like a cold. Do not stop taking your medicine unless your doctor tells you to.

If you have a cough that is a problem for you, then your doctor might give you an angiotensin II receptor blocker (ARB) instead. ARBs are less likely to cause a cough.

Interactions with other medicines

ACE inhibitors may interact with other medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), antacids, potassium supplements, certain diuretics, and lithium. If you are taking one of these medicines, talk with your doctor before you take an ACE inhibitor.

For tips on taking blood pressure medicine, see:

Click here to view an Actionset.High Blood Pressure: Taking Medicines Properly.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.

Checkups

Your doctor may check your potassium levels and how your kidneys are working to make sure this medicine is not causing problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Drugs for hypertension (2009). Treatment Guidelines From The Medical Letter, 7(77): 1–10.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Last Revised May 14, 2012

Last Revised: May 14, 2012

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Robert A. Kloner, MD, PhD - Cardiology

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