High Blood Pressure and ACE Inhibitors

Angiotensin converting enzyme (ACE) inhibitors are high blood pressure drugs that widen or dilate the blood vessels to improve the amount of blood the heart pumps and to lower blood pressure. ACE inhibitors also increase blood flow, which helps to decrease the amount of work your heart has to do and can help protect your kidneys from the effects of hypertension and diabetes.

ACE inhibitors are used to treat a number of heart-related conditions, including high blood pressure, heart failure, heart attack, and preventing kidney damage associated with high blood pressure and diabetes. Examples of ACE inhibitors include:

What Are the Side Effects of ACE Inhibitors?

Like any drug, an ACE inhibitor is likely to have some side effects. They may include:

  • Cough . If this symptom persists or is severe, contact your doctor. Ask your doctor what type of cough medicine you should use to control the cough.
  • Red, itchy skin or 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, and swelling of feet, ankles and lower legs. Contact your doctor if you have any of these symptoms.
  • Swelling of your neck, face, and tongue. See a doctor right away if you have any of these symptoms. These represent 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, and weakness or heaviness in legs. Contact your doctor right away if you have any of these symptoms.
  • Kidney failure. Although ACE inhibitors help to protect the kidneys, it can also cause kidney failure in some people.
  • 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.

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Guidelines for Taking ACE Inhibitors

  • ACE inhibitors should be 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.
  • Do not use salt substitutes while taking ACE Inhibitors. 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.
  • Avoid over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs like Aleve and Motrin). These drugs 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.
  • Have your blood pressure and kidney function checked regularly, as advised by your doctor, while taking this drug.
  • Never stop taking your medication, even if you feel that it is not working, without discussing it with your doctor first. 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.

Can Pregnant Women Take ACE Inhibitors?

Women should not take ACE inhibitors during pregnancy, especially during their second and third trimesters. ACE inhibitors can lower blood pressure and cause kidney failure or high potassium levels in the blood of the mother. They can cause death or deformity in the newborn.

It is recommended that babies not be breast fed if the mother is taking an ACE inhibitor, because the medicine can pass through breast milk.

Can Children Take ACE Inhibitors?

Yes, kids can take ACE inhibitors. However, children are more sensitive to the effects of these drugs on blood pressure. Thus, they are at higher risk of having severe side effects from the drug. Before giving this drug to children, parents are encouraged to discuss the potential benefits and risks with their pediatric cardiologist (heart doctor).

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on October 12, 2015

Sources

SOURCE: American Heart Association. 

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