ACEinhibitorrelated

ACE inhibitor–related refers to effects, adverse events, and clinical considerations associated with the class of medications known as angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors block the conversion of angiotensin I to angiotensin II, producing vasodilation and reduced aldosterone secretion. They are used to treat hypertension, heart failure with reduced ejection fraction, diabetic nephropathy, and to improve outcomes after certain cardiovascular events.

Common ACE inhibitor–related effects include decreased blood pressure, dizziness, and sometimes a persistent dry cough caused by bradykinin accumulation. Hyperkalemia, particularly in patients with chronic kidney disease, diabetes, or those taking potassium-sparing agents, is another frequent concern. Some patients develop acute changes in kidney function, especially if there is preexisting renal artery stenosis or other conditions affecting renal perfusion. Angioedema is a rare but serious ACE inhibitor–related adverse event that can be life-threatening and occurs more often in certain populations.

Serious adverse events and contraindications include angioedema that requires urgent treatment, acute kidney injury, and severe hyperkalemia. ACE inhibitors are contraindicated in pregnancy due to risk to the fetus, and bilateral renal artery stenosis is a traditional absolute contraindication. Use in patients with prior angioedema related to ACE inhibitors is generally avoided.

Monitoring and safety considerations involve checking blood pressure, serum creatinine, and potassium levels after initiation or dose changes, typically within one to two weeks, and periodically thereafter. Patients should be advised to report signs of swelling, difficulty breathing, or unusual fatigue, and to avoid NSAIDs or potassium supplements unless guided by a clinician, as these can affect kidney function or potassium levels. Interaction with other antihypertensives and diuretics may necessitate dose adjustments.