Angiotensin-converting enzyme inhibitor (ACE) inhibitor is a drug that serves to relax blood vessels. On the other hand, the drug can help reduce the amount of fluid that can be reabsorbed by the kidneys.
With both properties, ACE inhibitors are widely used to overcome hypertension (high blood pressure), heart failure, heart attacks, some diabetes-related diseases, as well as chronic kidney disease.
ACE inhibitors work by inhibiting enzymes in the body to produce hormone angiotensin 2 or substances that can narrow blood vessels and improve the work of the heart. With this drug, the blood vessels become dilated, so that the pressure on the blood vessels decreases, as well as the amount of fluid flowing in the blood vessels. The condition can help lower blood pressure and relieve heart work.
ACE inhibitors work by inhibiting the conversion of angiotensin I into angiotensin II. These classes of drugs are effective and generally well tolerated. In infants and children with heart failure, captopril is usually the main drug. Its use in children should be initiated by a specialist and with intensive monitoring.
Use of ACE inhibitors
ACE inhibitors are used to treat heart disease. These drugs make your heart more relaxed by lowering your blood pressure. This drug keeps some types of heart disease from getting worse. Most people who have heart failure take this drug.
These drugs treat high blood pressure, stroke, or heart attack. Medications can also help lower the risk of stroke or heart attack.
ACE inhibitors are also used to treat diabetes and kidney problems. The drug can help keep the kidneys from deteriorating. If you have this problem, ask your doctor if you should take this drug.
Benefits of ACE Inhibitors
The benefits of ACE- inhibitors are to reduce mortality and morbidity in all systolic heart failure patients (all degrees of severity, including asymptomatic one) and ACE-inhibitors have a very positive effect on hypertension sufferers.
In hypertension sufferers, the main abnormality will be seen in the media of the walls of blood vessels.
ACE inhibitors for heart failure
Treatment of chronic heart failure aims to reduce symptoms, increase endurance while exercise, reduces the incidence of acute exacerbations and lower mortality rates.
ACE inhibitors are used at all severity of heart failure, usually combined with diuretics.
Potassium supplements and potassium-sparing diuretics should be discontinued before starting the use of ACE inhibitors due to the risk of hyperkalemia.
Spironolactone may be beneficial in severe heart failure and can be used in addition to ACE inhibitors by intensively monitoring potassium serum levels.
Severe hypotension in the administration of the first dose of ACE inhibitors may occur when first administered in patients with heart failure who have been given high doses of strong diuretics before (e.g. Furosemide 80 mg a day or more).
Temporary discontinuation of strong diuretics can lower the risk, but it can likely lead to a severe pulmonary edema rebound.
Therefore, in patients who use high doses of strong diuretics, ACE inhibitors need to be administered under the supervision of a specialist.
ACE inhibitors can be administered in patients receiving low doses of diuretics or in patients who do not have a serious risk of hypotension. However, caution is still required and given a very low initial dose.
ACE Inhibitors Side Effects
Hypotension
At the beginning of an administration of ACE- inhibitors can usually cause side effects such as hypotension.
Dry Cough
Dry cough is the most common side effect in the use of this drug, it is more common in women and more common at night.
The side effects of this drug usually depend on the size of the dose and are reversible when the drug is discontinued.
Hyperkalemia
Another side effect of this drug is that it can cause hyperkalemia in patients with impaired renal function and other side effects.