What Are Angiotensin-Converting Enzyme Inhibitors?

Angiotensin-converting enzyme inhibitor (ACEI) has a hypotensive effect, which can delay and reverse ventricular remodeling, prevent the further development of myocardial hypertrophy, improve vascular endothelial function and cardiac function, reduce the occurrence of arrhythmia, and improve survival rate. Improve prognosis. The clinically used ACEIs include captopril, enalapril, benazepril, fosinopril, ramipril and the like.

Basic Information

Drug Name

Angiotensin-converting enzyme inhibitor

Foreign name

ACEI

Main indications

Hypertension, congestive heart failure and myocardial infarction

Adverse reactions

Dry cough, angioedema, hypotension, impaired renal function, etc.

Pharmacological effects of angiotensin-converting enzyme inhibitors

1. Reducing the production of angiotensin , inhibiting angiotensin converting enzyme, reducing the production of angiotensin , reducing the secretion of aldosterone, reducing the retention of water and sodium, reducing the amount of venous return to the heart, and reducing the preload of the heart. At the same time, it also reduces the degradation of bradykinin, which causes blood vessels to dilate, reduces peripheral resistance, reduces the load on the heart before and after, and increases cardiac output. Left ventricular end-diastolic pressure and volume decrease accordingly, ventricular wall tension decreases, renal vascular resistance decreases, and renal blood flow increases, which is also conducive to the improvement of cardiac function.

2. Prevents or reverses cardiovascular remodeling, inhibits myocardial and vascular hypertrophy, proliferates, delays or reverses ventricular and vascular remodeling, improves the heart's and blood vessel's diastolic function, and improves myocardial and blood vessel compliance.

Angiotensin-converting enzyme inhibitors

1. hypertension

ACEI has a good effect on hypertension, and patients with mild to moderate hypertension can control blood pressure by using ACEI alone. When the effect of single use is not good, the combination of diuretics can enhance the effect. Renovascular hypertension is particularly effective with ACEI because of its high renin levels. For patients with hypertension associated with heart failure or diabetes, kidney disease, ACEI is the drug of choice.

2. Congestive heart failure and myocardial infarction

ACEI can reduce the mortality of patients with heart failure, improve the prognosis of congestive heart failure, and prolong life, and its effect is better than other vasodilators and cardiotonics. ACEI can reduce the mortality of myocardial infarction and heart failure, improve hemodynamics and organ perfusion.

3 Diabetic nephropathy and other kidney diseases

Due to the increased internal pressure of the glomerulus, the glomerulus and renal function can be damaged. Diabetic patients often have renal lesions. ACEI can improve or prevent the deterioration of renal function in patients with type 1 and type 2 diabetes, with or without hypertension. In addition to polycystic kidney disease, renal dysfunction caused by other causes such as hypertension, glomerulonephritis, and interstitial nephritis also have a certain effect, and can reduce proteinuria.

Angiotensin-converting enzyme inhibitor adverse reactions

Common adverse reactions include dry cough, angioedema, hypotension, impaired renal function, and hyperkalemia. Occasionally, headache, dizziness, fatigue, nausea, hair loss, sexual dysfunction, cholestatic jaundice, acute pancreatitis, intramuscular painful contracture, etc.

Precautions for angiotensin-converting enzyme inhibitors

Those who are allergic to this class of drugs are prohibited. Patients with angioedema, pregnancy-induced hypertension, severe renal impairment or hyperkalemia are contraindicated. Use with caution in patients with severe anemia, constrictive pericarditis, hypertrophy or restricted cardiomyopathy, and unexplained renal insufficiency.

Hyperkalemia can occur when coadministered with non-steroidal anti-inflammatory drugs and potassium-preserving diuretics, and combined with the latter can exacerbate renal failure; combined with diuretics or other antihypertensive drugs can enhance the antihypertensive effect, such as with The combination of diuretics can increase the antihypertensive effect of ACEI, and ACEI can antagonize the effect of diuretics on increasing renin levels without increasing side effects.

(Note: The above content is only for introduction, the drug use must be carried out by a regular hospital under the guidance of a doctor.)