Drug treatments: ACE inhibitors

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Angiotensin Converting Enzyme ("ACE") inhibitors have successfully treated all types of high blood pressure. Many brands are available that are similar in safety and effectiveness.

ACE inhibitors include:

Captopril (Capoten)
Enalapril (Vasotec)
Quinapril (Accupril)
Benazepril (Lotensin)
Lisinopril (Prinivil, Zestril)
Ramipril (Altace)
Perindopril (Aceon)
Trandolapril (Mavik)

ACE inhibitors are often recommended as first-line treatment for people with diabetes and kidney damage, heart attack survivors, stroke patients, and those with heart failure, particularly when taken with diuretics. They can also improve a person's odds of surviving after a heart attack and stroke.

Side effects

Side effects are uncommon but may include:

Irritating cough.
Excessive drops in blood pressure.
Allergic reactions.
Angiodema -- a swelling of the subcutaneous tissue that may lead to swelling of the face and upper airways and cause breathing problems.
Although ACE inhibitors can protect against kidney disease, they also cause the kidneys to retain potassium, which can result in arrhythmias (abnormal heart rhythms) or even cardiac arrest if levels become too high. Because of this, they are not generally given with potassium-sparing diuretics or potassium supplements.
One rare but severe side effect -- granulocytopenia -- has been observed, which is an extreme reduction in white blood cells.

Always tell your physician about all of the medications you are taking to make sure there are no potential risks. This includes over-the-counter medications (such as aspirin and ibuprofen) which may have harmful interactions with ACE inhibitors.

Review Date: 6/8/2011
Reviewed By: Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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