ACE inhibitors – when should you take them?

Angiotensin converting enzyme inhibitors were introduced into the pharmaceutical circulation in 1981. The first oral formulation available was captopril. Currently, angiotensin converting enzyme inhibitors are used in health ailments related mainly to cardiovascular problems, as well as in the treatment of diabetic nephropathy and prevention of stroke. As problems with high blood pressure become more common, angiotensin converting enzyme inhibitors are one of the most prescribed drugs today.

ACE inhibitors work by blocking the action of angiotensin converting enzyme, the enzyme that catalyses the conversion of angiotensin I into angiotensin II. Angiotensin II is a hormone primarily responsible for causing contractions in the blood vessels, increasing aldosterone and, consequently, regulating blood pressure. It is also responsible, inter alia, for the body’s water and electrolyte homeostasis and the secretion of other hormones. By inhibiting the action of angiotensin converting enzyme, the increase in pressure is stopped.

When is ACE inhibitors recommended?

Angiotensin converting enzyme inhibitors are used relatively frequently. The ailments treated with their help include, first of all:

  1. heart failure
  2. heart rhythm problems such as atrial fibrillation
  3. diabetes
  4. kidney failure
  5. ischemic heart disease (known as coronary artery disease)
  6. atherosclerosis.

Since angiotensin converting enzyme inhibitors are used primarily in the treatment of problems with arterial hypertension, their intake should be combined with other forms of therapy. The best way is to change basic life habits such as diet and daily exercise. We will support the fight against hypertension by limiting the amount of salt in the consumed food, reducing our body weight and undertaking regular physical activity. Then pharmacotherapy becomes a method supporting other, natural forms of fighting hypertension. Improving your physical condition may also affect the dose you take, reducing the amount you take.

Check how Zofenil works – a drug whose active ingredient is zofenopril

Although ACE inhibitors are relatively safe and proven drugs, they can cause unwanted side effects. The most common are:

  1. excessively low blood pressure,
  2. problems with the functioning of the kidneys,
  3. cough,
  4. angioedema
  5. increase in the level of potassium in the blood (hyperkalaemia).

People taking ACE inhibitors should check their blood pressure at regular intervals. Pressure control is very serious due to the individual predisposition and susceptibility to the influence of medications in the treatment of pressure. In some cases, angiotensin converting enzyme inhibitors cause an excessive reduction in blood pressure, which may pose a threat to the health and even life of patients. Increased occurrence of any of the side effects should be reported to the physician.

Contraindications in taking angiotensin converting enzyme inhibitors

Since angiotensin converting enzyme inhibitors affect blood pressure, there are a number of contraindications to their use. These include:

  1. pregnancy,
  2. the period of breastfeeding,
  3. allergies to any of the ingredients of the drug,
  4. occurrence of dry and intense cough after other drugs from the same group,
  5. bilateral stenosis of the renal artery,
  6. angioedema
  7. excessive drop in blood pressure caused by taking substances belonging to the same group,
  8. idiopathic hypertrophic subaortic stenosis.

In addition, the use of angiotensin converting enzyme inhibitors is not recommended if the level of creatinine (over 2,5 mg / dl) or potassium (over 5,0 mmol / l) is too high.

Classification of ACE inhibitors

ACE inhibitors can be divided into several groups according to the chemical structure or pharmacological properties of the drug (trade names are given in brackets).

Due to the chemical structure, we distinguish the following groups:

  1. drugs with a sulfhydryl group (captopril, xyapril, zofenopril),
  2. drugs with a carboxyl group (benazepril, quinapril, enalapril and others),
  3. drugs with a phosphinic acid residue (fosinopril).

Based on the pharmacological properties, we can distinguish the following groups of angiotensin converting enzyme inhibitors:

  1. active compounds, metabolized into further forms after ingestion (capropril),
  2. inactive compounds, metabolized into active metabolites (enalapril, benazepril, cilazapril),
  3. compounds that do not activate inside the body, are excreted in the urine in the same form in which they are ingested (lysinopril).

Each of the three groups above differs in terms of the way it is absorbed, distributed, metabolized and excreted from the body.

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