ACE inhibitors are a group of medicines commonly used to treat hypertension (high blood pressure) and related conditions. Patients with congestive heart failure where the pumping action of the heart is reduced causing a build up of fluid within the lungs may also be treated with ACE inhibitors. More recently the medicines have also been found to be beneficial to people with impaired kidney function. Patients with diabetes are at risk of any or all of these symptoms and are commonly prescribed ACE inhibitors.
HOW DO ACE INHIBITORS WORK?
ACE is an abbreviation of angiotensin converting enzyme which is a substance produced in the body to activate angiotensin. Angiotensin works on the wall of the arteries and arterioles in the body causing them to constrict. When this occurs the lumen of these blood vessels in the body becomes smaller causing blood to be pumped through them with greater force which in turn raises blood pressure. Angiotensin also works on the kidneys and helps them to control the amount of water reabsorbed into the body after urine has been produced. ACE inhibitors limit the activation of angiotensin causing blood pressure to lower, the desired effect in patients with hypertension. In congestive cardiac failure the reduced pumping action of the heart causes greater blood volume to be circulating in the body. This results in generalised fluid accumulation within the lungs and lower legs (oedema) increasing the strain on the heart and causing patients difficulty to have difficulty in breathing (dyspnoea). By increasing the gauge of the arteries and acting on the kidneys to reabsorb less water; ACE inhibitors allow the increased blood volume to circulate more easily and help to relieve symptoms. In patients with reduced kidney function ACE inhibitors can help prevent further damage to the kidney’s tissues from hypertension.
WHAT ARE THE SIDE EFFECTS OF ACE INHIBITORS?
The most common side effect of these medicines is a chronic dry cough. Less commonly patients may complain of fatigue, a rash or low blood pressure (hypotension). Sometimes patients find that changing from one medicine to another can help to alleviate side effects.
ACE inhibitors can be recognized by the suffix ‘pril’ at the end of their name. Captopril, Ramipril, Lisinopril, Benazipril and Quinapril are some common examples.
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