Angiotensin-converting enzyme (ACE) inhibitors are medicines used to treat high blood pressure, heart attack and heart failure. They help your blood vessels to widen and relax which lowers your blood pressure and improves blood flow.
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About ACE inhibitors
What are ACE inhibitors?
Angiotensin-converting enzyme (ACE) inhibitors are medicines that help your blood vessels to widen and relax. This helps lower your blood pressure and improves blood flow.
ACE inhibitors may not be suitable for you if you’re over 55 or of African or Caribbean descent. There are other medicines that may be more effective for you. Speak to your doctor about your treatment options if this applies to you.
How do ACE inhibitors work?
ACE inhibitors stop your body from producing a hormone called angiotensin II.
This hormone increases your blood pressure by:
Making your blood vessels contract so they become narrower and your blood has less space to move.
Making your body hold onto more water in your blood which puts pressure on your blood vessels.
By reducing the hormone, ACE inhibitors make your blood vessels widen and relax. They also help remove extra fluid from your blood. This lowers your blood pressure and improves blood flow to your heart.
Video: How do ACE inhibitors work?
Types of ACE inhibitors
What are the different types of ACE inhibitors?
There are different types of ACE inhibitors. Some common types include:
ramipril
captopril
enalapril
lisinopril
perindopril.
Find out more about these medicines on the NHS website.
The main difference between ACE inhibitors is how long their effects last. Some are short-acting and others are long-acting. For example, perindopril is long-acting and only needs to be taken once a day. Captopril is short-acting and needs to be taken 3 times a day.
You will usually be given a low-strength medicine first and your dose will be increased if it’s needed.
Side effects
What are the side effects of ACE inhibitors?
All medicines have potential side effects, but most people will not experience side effects.
Side effects of ACE inhibitors may include:
dry cough
dizziness
headache
swelling around the mouth, face or throat
feeling more tired than usual (fatigue)
weakness
low sodium and high potassium (electrolyte imbalance).
Different medicines have different side effects. If you’ve started taking ACE inhibitors recently it’s worth bearing in mind that symptoms with any new medicine may improve over time or even disappear.
You’ll have your blood pressure tested regularly while taking an ACE inhibitor. You should also have a regular blood test. This checks how your kidneys are working and your electrolyte levels.
When should I get help?
Talk to your doctor if you’re having side effects. They can help you manage them or look at other options with you.
If you have side effects when taking an ACE inhibitor, your doctor may prescribe a different type of medicine called an angiotensin-II receptor blocker (ARB).
It’s important not to stop taking your medicine without speaking to a healthcare professional first.
How and when to take them
How do I take this medicine?
Most people will take an ACE inhibitor once a day. Try and take it at the same time every day.
How often you take your medicine will depend on the type of ACE inhibitor you’ve been prescribed and the dose.
Your doctor will give you more information about the type of ACE inhibitor they’re giving you and how often you should take it.
If you forget to take your medicine and:
It's only a short time after your usual dose, take it as soon as you remember. Then take your next dose at the usual time.
It’s nearly time for your next dose, do not take the one you missed. Wait and take your next dose at the usual time.
How long do I take it for?
Most people with high blood pressure will need to take medicines to lower their blood pressure long-term.
You will need to check your blood pressure regularly to make sure it’s under control. If your blood pressure is not under control, speak to your doctor. They may recommend increasing the dose of your medicine or trying an alternative or additional medicine.
It’s important not to stop taking your medicine without speaking to a healthcare professional first.
Things to avoid if you’re taking ACE inhibitors
It’s important to check with your doctor or pharmacist before taking any other medicine while you’re taking ACE inhibitors.
There are certain foods and over-the-counter medicines you may need to limit or avoid if you’re taking an ACE inhibitor. This is because they can stop your medicine from working properly.
This includes:
foods high in salt
NSAID medicines, like ibuprofen and naproxen
medicines high in sodium, such as indigestion remedies like Gaviscon and cystitis medicines like CanesOasis.
You should not take ACE inhibitors if you’re pregnant. If you’re currently taking ACE inhibitors and you’re planning to get pregnant or you become pregnant, speak to your doctor.
Get help with ACE inhibitors
Our cardiac nurses can help answer your questions on ACE inhibitors. Call, email or live chat with them on our Heart Helpline.
This booklet can help you and your loved ones understand what high blood pressure is and how to make healthier changes to look after your heart health.
To find out more, or to support British Heart Foundation’s work, please visit www.bhf.org.uk. You can speak to one of our cardiac nurses by calling our helpline on 0808 802 1234 (freephone), Monday to Friday, 9am to 5pm. For general customer service enquiries, please call 0300 330 3322, Monday to Friday, 9am to 5pm.
British Heart Foundation is a registered Charity No. 225971. Registered as a Company limited by guarantee in England & Wales No. 699547. Registered office at Greater London House, 180 Hampstead Road, London NW1 7AW. Registered as a Charity in Scotland No. SC039426