Angiotensin-Converting Enzyme (ACE) Inhibitors for Heart Failure
ACE inhibitors combined with diuretic
How It Works
Angiotensin-converting enzyme (ACE) inhibitors block the activity of an enzyme that causes blood vessels to constrict (narrow). As a result, blood vessels relax and widen (dilate), making it easier for blood to flow through the vessels, which reduces blood pressure.
Preventing blood vessels from narrowing helps improve blood flow, reduces the backup of blood in the heart and lungs, and decreases the pressure that the heart's left chamber (ventricle) must pump against.
These medicines also increase the release of water and salt (sodium) to the urine, which lowers blood pressure. ACE inhibitors (and angiotensin II receptor blockers, also called ARBs) also act directly on the hormones that regulate sodium and water balance in the body.
Why It Is Used
People with systolic heart failure, which is caused by left ventricular dysfunction, will probably be given an ACE inhibitor if possible.
ACE inhibitors may be used for people with symptoms of heart failure and for people without symptoms.
People who should not take ACE inhibitors include:
How Well It Works
In people who have symptoms of heart failure
ACE inhibitors can:1
In people who may not have symptoms of heart failure but who have had a heart attack
ACE inhibitors are often started in people who have recently had a heart attack and who have a damaged or weakened left ventricle but who do not yet have symptoms of heart failure. In these people, ACE inhibitors have been found to reduce death rates when started soon after the heart attack.1
Side effects of ACE inhibitors may include:
ACE inhibitors may interact with 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 taking any other medicines.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Usually, ACE inhibitors cause very few side effects. The most common side effect is an irritating dry cough. Most people find the cough to be a minor problem that they can live with in exchange for the benefits of this medicine. If you take an ACE inhibitor and have a problem with coughing, then you might take an angiotensin II receptor blocker (ARB) instead. ARBs are less likely to cause a cough. ARBs have been shown to work as well as ACE inhibitors for heart failure.2
ACE inhibitors are one of the first choices in drugs for treating heart failure.
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