Heart Disease: Heart Disease Medicine: ACE Inhibitors

Angiotensin converting enzyme (ACE) inhibitors are heart medications that widen or dilate your blood vessels to improve the amount of blood your heart pumps and lower blood pressure. ACE inhibitors also increase blood flow, which helps to decrease the amount of work your heart has to do. Examples of ACE inhibitors include:

• Capoten (captopril)
• Vasotec (enalapril)
• Prinivil, Zestril (lisinopril)
• Lotensin (benazepril)
• Monopril (fosinopril)
• Altace (ramipril)
• Accupril (quinapril)
• Aceon (perindopril)
• Mavik (trandolapril)
• Univasc (moexipril)

For What Conditions Would I Be Prescribed an ACE Inhibitor?

• High blood pressure.
• Heart failure. ACE inhibitors are critical in the treatment of heart failure.
• Heart attack. When given shortly after a heart attack, some ACE inhibitors can prevent some of the damage to the heart and improve the survival rate of heart attack patients.
• Diabetes. Some ACE inhibitors have been found to slow the process that leads to kidney damage in many type 2 diabetics.
• Heart disease prevention. In high-risk individuals, ACE inhibitors have been shown to decrease the risk of having a heart attack or stroke.

How Should I Take ACE Inhibitors?

These medications are usually taken on an empty stomach one hour before meals. Follow the label directions on how often to take this medication. The number of doses you take each day, the time allowed between doses, and how long you need to take the medication will depend on the type of ACE inhibitor prescribed, as well as your condition.

While taking this medication, have your blood pressure and kidney function checked regularly, as advised by your doctor.

Never stop taking your medication, even if you feel that it is not working. If you are taking ACE inhibitors for heart failure, your heart failure symptoms may not improve right away. However, long-term use of ACE inhibitors helps manage chronic heart failure and reduces the risk that your condition will become worse.

Should I Be Concerned About Food and Drug Interactions While Taking an ACE Inhibitor?

Yes. While taking an ACE inhibitor, do not use salt substitutes. These substitutes contain potassium and ACE inhibitor medications cause the body to retain potassium. Learn how to read food labels to choose low-sodium and low-potassium foods. A dietitian can help you select the right foods.

Over-the-counter nonsteroidal anti-inflammatory medications (like Aleve and Motrin) and aspirin may cause the body to retain sodium and water, and decrease the effect of an ACE inhibitor. Check with your doctor before taking any anti-inflammatory medications.

It is important that your doctor is aware of all the medications you are taking, as some (in addition to those listed above) may potentially interact with ACE inhibitors. Talk to your doctor before taking any new medication, including over-the-counter drugs, herbs and supplements.

What Are the Side Effects?

Possible side effects when taking ACE inhibitors:

• Cough. If this symptom persists or is severe, contact your doctor. Ask your doctor what type of cough medicine you may use to control the cough.
• Red, itchy skin rash. Contact your doctor; do not treat the rash yourself.
• Dizziness, lightheadedness or faintness upon rising. This side effect may be strongest after the first dose, especially if you have been taking a diuretic (water pill). Get up more slowly. Contact your doctor if these symptoms persist or are severe.
• Salty or metallic taste or a decreased ability to taste. This effect usually goes away as you continue taking the medication.
• Physical symptoms. Sore throat, fever, mouth sores, unusual bruising, fast or irregular heartbeat, chest pain, swelling of feet, ankles, lower legs. Contact your doctor if you have any of these symptoms.
• Swelling of your neck, face and tongue. Contact your doctor right away if you have any of these symptoms. This is a serious emergency.
• High potassium levels. This is a potentially life-threatening complication. Therefore, people on ACE inhibitors should regularly have blood tests to measure potassium levels. Signs of too much potassium in the body include confusion; irregular heartbeat; nervousness; numbness or tingling in hands, feet or lips; shortness of breath or difficulty breathing; weakness or heaviness in legs. Contact your doctor right away if you have any of these symptoms.
• Severe vomiting or diarrhea. If you have severe vomiting or diarrhea you may become dehydrated, which can lead to low blood pressure. Contact your doctor right away.

Also contact your doctor if you have any other symptoms that cause concern.