Angiotensin-converting Enzyme (ACE) Inhibitors & Angiotensin II Receptor Blockers (ARB)

Overview

Angiotensin-converting Enzyme (ACE) Inhibitors and Angiotensin II Receptor Blockers (ARBs) are used primarily in the management of hypertension (high blood pressure). These medications are also used in the treatment of kidney disease from diabetes (diabetic neuropathy) and heart failure. ACE inhibitors rather than ARBs tend to be the medication of choice for heart failure and diabetic neuropathy unless side effects of an ACE inhibitor cannot be tolerated. ACE Inhibitors and ARBs work by acting on chemicals produced by the kidney. ACE Inhibitors block an enzyme in the body that is necessary to produce a substance that causes blood vessels to tighten. The results of these chemical reactions is a relaxing of the blood vessels, a lowering of blood pressure and an increase of blood supply and oxygen to the heart.

Angiotensin II Receptor Blockers (ARBs) work by blocking the effects of a hormone called angiotensin II, which produces several effects, including constriction of the blood vessels; increased salt and water retention; activation of the sympathetic nervous system; blood vessel stimulation and heart fibrosis (stiffening); and promotion of heart cell growth. These effects result in increased blood pressure and in some situations can be harmful to the heart and kidneys.

Side Effects

Common side effects include low blood pressure, cough, hives, headache and tiredness. Coughing and skin rashes or hives are more commonly associated with ACE Inhibitors.

Drug Names

The following is a list of commonly used ACE Inhibitors and ARB's (brand name in brackets)

• Benazepril (Lotensin)
• Captopril (Capoten)
• Enalapril (Vasotec)
• Fosinopril (Monopril)
• Lisinopril (Prinivil, Zestril)
• Moexipril (Univasc)
• Perindopril (Aceon)
• Quinapril (Accupril)
• Ramipril (Altace)
• Trandolapril (Mavik)
• Telmisartan (Micardis)
• Eprosartan (Teveten)
• Valsartan (Diovan)
• Candesartan (Atacand)
• Losartan and Hydrochlorothiazide (Hyzaar)
• Losartan (Cozaar)

For more specific information on ACE Inhibitors & ARBs, you may visit the National Library of Medicine's MEDLINEplus Drug Information section.

Author: James Joseph, MD