Angiotensin-converting enzyme inhibitors

Abstract

ACE inhibitors have enjoyed a lengthy history of use. The first application of ACE inhibitors was in the treatment of hypertension where they were shown to reduce blood pressure in a not insignificant number of individuals with hypertension. Soon these compounds were also being routinely employed in disease states such as heart failure, chronic kidney disease, and coronary artery disease. The results of large carefully conducted studies validated what was as first the empiric use of these compounds in such end-organ disease conditions. Innumerable ACE inhibitors are available and the concept of class effect is now a routine topic of discussion for these compounds. Class effect is an acceptable viewpoint when ACE inhibitor- related blood pressure reduction is being considered; however, it is a somewhat awkward concept when it is applied to the end-organ protection seen with ACE inhibitors. ACE inhibitor side-effects include cough, angioneurotic edema, functional renal insufficiency, and hyperkalemia. Angioneurotic edema is a class effect with all ACE inhibitors and is potentially life-threatening. Other ACE inhibitor-related side-effects are not common causes for discontinuation of these drugs.