Angiotensin-Converting Enzyme (ACE) Inhibitors for Coronary Artery Disease

How It Works

Angiotensin-converting enzyme (ACE) inhibitors interfere with the formation of a hormone (angiotensin II) that can narrow (constrict) blood vessels. ACE inhibitors help lower blood pressure and reduce the workload on the heart, which lowers the chances of heart attack.

Why It Is Used

ACE inhibitors are recommended for people who have coronary artery disease, particularly those who also have diabetes. They may lower your risk for a future heart attack or heart failure. These drugs frequently are also used to treat high blood pressure and heart failure.

How Well It Works

ACE inhibitors help lower blood pressure and reduce the workload on the heart, which lowers the chances of a heart attack. They also help people who have heart failure to live longer. And they slow the development of kidney failure in people who have diabetes.

Side Effects

Side effects may include:

• Cough. A cough is one of the most common side effects of ACE inhibitors. Most people find the cough to be a minor problem that they can tolerate in exchange for the benefits of this medicine. If coughing is a severe problem, other medicines can be tried.
• Low blood pressure. Another side effect of ACE inhibitors may be low blood pressure, which may cause symptoms of dizziness, weakness, or fainting. People with low to normal blood pressure generally will be started on a low dose of medicine and need to have their blood pressure monitored regularly.
• Swelling. Swelling in the face, neck, lips, throat, hands, feet, or genitals rarely may occur when using ACE inhibitors. If swelling affects the face or throat, it can interfere with breathing. If this occurs, notify your doctor immediately.
• High potassium levels. A high potassium level can disrupt the normal electrical impulses in the heart, leading to irregular heartbeats (arrhythmias). Potassium levels are monitored with blood tests.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

If you are pregnant or may become pregnant, do not take ACE inhibitors.

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.

ACE inhibitors may interact with other medicines such as pain relievers called NSAIDs (nonsteroidal anti-inflammatory drugs), antacids, potassium supplements, certain diuretics, and lithium. If you are taking one of these medicines, talk with your doctor before taking an ACE inhibitor.

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