ACE Inhibitors and Heart Disease

Angiotensin-converting enzyme (ACE) inhibitors are heart medications that widen, or dilate, your blood vessels. That increases the amount of blood your heart pumps and lowers blood pressure.

They also raise blood flow, which helps to lower your heart’s workload.

Examples of ACE inhibitors include:

Why Are They Prescribed?

Of course, they’ll help manage high blood pressure. But your doctor may prescribe an ACE inhibitor for these other heart conditions:

Heart failure: They can prevent further weakening of your heart and prolong your life.

Heart attack: When given after one, some ACE inhibitors may lessen the impact on your heart strength and help you live longer.

Diabetes: Some can slow the process that leads to kidney damage in many people with type 2 diabetes.

Heart disease prevention: If you’re at high risk, they’ve been shown to lessen your chance of having a heart attack or stroke.

How Should I Take Them?

Usually on an empty stomach, an hour before meals. Follow the directions on the label about how often to take it. The number of doses you take each day, the time between them, and how long you’ll need to take it will depend on the type of ACE inhibitor you’re prescribed, and your condition.

While taking them, have your doctor check your blood pressure and kidney strength regularly.

Never stop taking an ACE inhibitor without first discussing with your doctor.. If you’re taking them for heart failure, your symptoms may not improve right away. However, long-term use helps manage chronic heart failure and lessen the chance that your condition will get worse.

Will My ACE Inhibitor Interact With Any Foods or Drugs?

It may. Don’t use salt substitutes unless your doctor or nurse approves. Some contain potassium, and since ACE inhibitor medications cause the body to retain potassium, it can be dangerous to your health. Read food labels to choose foods low in salt and potassium. A dietitian can help, too.

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

It’s important for your doctor to know about all the drugs you are taking. Some, in addition to those above, may not work well with ACE inhibitors.

Talk to your doctor before taking any new medicines, including over-the-counter drugs, herbs, and supplements.

What Are the Side Effects?

Possible ones include:

Cough: If this persists or is severe, contact your doctor. Ask what type of cough medicine you can use to ease it.

Red, itchy skin rash: If you have this, don’t treat the rash yourself. Call your doctor.

Dizziness, lightheadedness, or faintness when you get up: This may be strongest after your first dose, especially if you’ve been taking a water pill (diuretic). Get up more slowly. If it keeps up, reach out to your medical team.

Salty or metallic taste, or a decreased ability to taste: This usually goes away as you continue taking the medicine.

Physical symptoms: Call your doctor if you have:

• Sore throat
• Fever
• Mouth sores
• Unusual bruising
• Fast or irregular heartbeat
• Chest pain
• Swelling of feet, ankles, or lower legs

Swelling of your neck, face, and tongue: Contact your doctor right away if you have any of these. This is a potential emergency.

High potassium levels: This is a potentially life-threatening complication. Therefore, people on ACE inhibitors should have blood tests regularly to measure potassium levels.

Signs of too much in your body include:

• Confusion
• Irregular heartbeat
• Nervousness
• Numbness or tingling in hands, feet, or lips
• Shortness of breath or difficulty breathing
• Weakness or heaviness in your legs

Contact your doctor right away if you have any of these.

Severe vomiting or diarrhea: These can make you dehydrated. That can lead to low blood pressure. Call your doctor right away.

Also reach out to your medical team if you have any other symptoms that concern you.

Can Pregnant Women Take Them?

Women should not take them during pregnancy, especially during the second and third trimesters. They 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.

Babies shouldn’t be breastfed if the mother is taking an ACE inhibitor. The medicine can pass through breast milk.

Can Children Take Them?

The short answer is yes. However, kids are more sensitive to the effects of them on their blood pressure. So, they’re at higher risk of severe side effects.

Before giving an ACE inhibitor to a child, discuss the potential benefits and risks with your pediatric cardiologist (heart doctor).

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