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ACE inhibitor

life science Maturity 11-13 Next article →

ACE inhibitors are a special group of medicines. Doctors use them to treat high blood pressure and heart failure. They are also used for kidney diseases and heart attacks. Some people use them to help with problems after a kidney transplant. These drugs can even help people with schizophrenia who drink too much water.

They work by changing how the body manages its blood pressure system. This system is called the renin-angiotensin-aldosterone system, or RAAS for short.

To understand how they work, we must look at a tiny worker called an enzyme. An enzyme is a part of the body that helps change one thing into another. This specific enzyme is called angiotensin-converting enzyme, or ACE. Normally, ACE turns a substance called angiotensin I into angiotensin II. Angiotensin II is a vasoconstrictor, which means it makes blood vessels narrow. When vessels narrow, blood pressure goes up. ACE inhibitors block this enzyme so that angiotensin II cannot form.

These medicines do more than just stop the narrowing of vessels. They also change how the body handles a substance called bradykinin. Usually, the ACE enzyme breaks bradykinin down. Because the medicine blocks the enzyme, more bradykinin stays in the body. Bradykinin is a vasodilator, which is a word for something that helps vessels open wide. The increase in bradykinin works together with the decrease in angiotensin II. This combination helps lower blood pressure effectively.

There are many different names for these medicines. Some common ones include captopril, enalapril, and lisinopril. Other names you might see are benazepril, zofenopril, perindopril, trandolapril, and ramipril. Doctors often choose these drugs first if a patient has diabetes. In 2012, a study in the BMJ showed these drugs might help reduce the risk of pneumonia. For people who had a stroke, the risk dropped by 54%. For those with heart failure, the risk dropped by 37%.

Even though these drugs help, they can cause side effects. A very common one is a dry cough. Some people might feel dizzy, tired, or have a headache. These drugs can also cause high potassium levels in the blood. This is called hyperkalemia, and it can make muscles feel weak. It is also very important that pregnant women do not take these medicines. They can cause serious health problems for a growing baby.

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