Angiotensin-converting enzyme inhibitors, or ACE inhibitors, are medications that lower your blood pressure. They interfere with how your body converts angiotensin into a form that raises your blood pressure. These drugs can treat cardiovascular conditions like high blood pressure, heart failure, kidney problems and more.
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Angiotensin-converting enzyme inhibitors (ACE inhibitors or ACE-I, for short) are medicines that can lower your blood pressure and protect your kidneys. Healthcare providers often use this drug class to treat cardiovascular (heart and blood vessel) conditions like high blood pressure.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
ACE inhibitors help with:
ACE inhibitor medications also treat several kidney diseases in people who don’t have diabetes, including:
ACE inhibitor medications work just like the name suggests. They keep angiotensin-converting enzyme (ACE) from converting angiotensin (AN-gee-oh-ten-sin) I into angiotensin II.
Angiotensin II raises blood pressure in multiple ways, like tightening your blood vessels and limiting how much salt and water your kidneys remove from your body. ACE also breaks down bradykinin, a protein that relaxes your blood vessels and helps your kidneys remove sodium from your body. Both actions help your blood pressure go down.
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Reducing the amount of angiotensin II in your body is an effective way to lower blood pressure. Blocking ACE means there’s less angiotensin II to raise your blood pressure, and there’s more bradykinin to lower your blood pressure. That means better blood pressure readings for you.
Examples of ACE inhibitors include:
You take all of these ACE inhibitor drugs by mouth except for enalaprilat. You receive this through an IV in your arm.
Healthcare providers often make ACE inhibitors their first choice for treating high blood pressure and other cardiovascular conditions. This is because:
Most side effects of ACE inhibitors are minor, but some are serious and need immediate medical care.
In general, the most common side effects for almost all ACE inhibitors include:
Less common ACE inhibitor side effects include:
Some ACE inhibitor medications can start working one hour after you take them. You should take certain ACE inhibitors one hour before eating a meal. This is because having food in your digestive system may lower your body’s ability to absorb the medicine by about 30% to 40%. Your provider can tell you if you should take your medicine before eating.
If you miss a dose of your ACE inhibitor — unless it’s closer to the time for your next dose than the one you missed — you should take the dose as soon as possible. If it’s been too long, wait and take only the next dose. Don’t take more than your prescribed dose to “catch up” because this can make your blood pressure too low.
You shouldn’t stand up too quickly after you start taking angiotensin-converting enzyme inhibitors. Standing up too quickly can make you feel dizzy or pass out.
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Keep taking ACE inhibitors as prescribed. Talk to your healthcare provider before you stop taking these medications. Stopping them suddenly can cause a heart attack, stroke or worsening heart failure. If you’re having bad side effects, your healthcare provider can help you switch to another drug.
At least once a year, your provider will check your kidney function and electrolyte levels. This may involve blood and urine testing. If your levels are abnormal or your kidneys aren’t working well, your provider may adjust your ACE inhibitor dose.
Some general reasons for avoiding angiotensin-converting enzyme inhibitors include:
Providers recommend switching medicines before trying to get pregnant.
ACE inhibitor drugs can interact with many medications. A few possible serious interactions include:
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Your provider may want you to avoid or limit salt in the foods you eat. You may also want to avoid salt substitutes that contain potassium until you talk to your provider about whether they’re right for you.
While it isn’t dangerous, capsaicin — the chemical compound that makes foods like peppers spicy — can sometimes worsen an ACE inhibitor-related cough.
You should seek immediate medical attention if you experience any of the following while taking ACE inhibitors:
With so many different types of blood pressure medicines around, it can be hard to know what’s what. ACE inhibitors are some of the first blood pressure medicines providers prescribe. They work well for many people. If you have questions about these medications, don’t hesitate to ask your provider.
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Last reviewed on 12/03/2024.
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