Health Library Angiotensin-Converting Enzyme (ACE) Inhibitors for Heart Attack and Unstable AnginaFrom Healthwise

Angiotensin-converting enzyme (ACE) inhibitors interfere with the formation of a hormone (angiotensin II) that can narrow (constrict) blood vessels. ACE inhibitors help lower blood pressure and reduce the workload on the heart, which lowers the chance of a heart attack.

ACE inhibitors are recommended immediately after a heart attack to reduce complications. These drugs frequently are used to treat high blood pressure and heart failure.

ACE inhibitors often are used for people who have recently had a heart attack and who have heart failure or decreased function of the left ventricle (lower left heart chamber). Use of ACE inhibitors following a heart attack can help prevent heart failure and may improve survival.

If used within 24 hours of the start of heart attack symptoms, ACE inhibitors reduce the risk of future death associated with a heart attack.¹

Side effects may include:

• Cough. A cough is one of the most common side effects of ACE inhibitors. Most people find the cough to be a minor problem that they can tolerate in exchange for the benefits of this medicine. If coughing is a severe problem, other medicines can be tried.
• Low blood pressure. Another side effect of ACE inhibitors may be low blood pressure, which may cause symptoms of dizziness, weakness, or fainting. People with low to normal blood pressure generally will be started on a low dose of medicine and need their blood pressure monitored regularly.
• Swelling. In rare cases, swelling in the face, neck, lips, throat, hands, feet, or genitals may occur with ACE inhibitors. If swelling affects the face or throat, it can interfere with breathing. If this occurs, notify your doctor immediately.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

A cough is one of the most common side effects of ACE inhibitors. Most people find the cough to be a minor problem that they can tolerate in exchange for the benefits of this medicine. If a person is taking an ACE inhibitor and has a real problem with coughing, then he or she may use an angiotensin II receptor blocker (ARB) instead. Angiotensin II receptor blockers (ARBs) such as losartan, valsartan, and irbesartan (approved for high blood pressure) do not cause a cough.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Danchin N, Durand E (2006). Acute myocardial infarction, search date August 2004. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Author:	Robin Parks, MS	Last Updated: May 14, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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