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inhibidores de la ECA

ACE inhibitors are medicines that are used mainly in the treatment of high blood pressure (hypertension) and heart failure. They are also used in some people with diabetes, for some forms of kidney disease, and after a heart attack, to help protect the heart.

They have a variety of effects on the body. Their ability to relax blood vessels is one of the most important. The side-effects most commonly associated with ACE inhibitors are usually minor. A common side-effect is a persistent dry cough.

At a glance

  • ACE inhibitors are medicines used to treat high blood pressure, heart failure, and kidney conditions.

  • They work by blocking a hormone that tightens blood vessels and increases water in the body.

  • Common side-effects include low blood pressure, dizziness, and a persistent dry cough.

  • You should not take ACE inhibitors if you are pregnant or breastfeeding.

  • Tell your doctor about all other medicines you are taking, including purchased ones.

  • Report any suspected side-effects via the Yellow Card Scheme.

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What conditions are ACE inhibitors used to treat?

Angiotensin-converting enzyme (ACE) inhibitors are used to treat a number of different conditions:

Estos incluyen:

Each of these medicines also has various different brand names. Some ACE inhibitor medicines are also part of a combined tablet with a calcium-channel blocker medicine o 'water tablet' (diuretic) medicine.

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ACE inhibitors prevent the body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme.

Angiotensin II has three main effects:

  • Tightening (constriction) of blood vessels.

  • Re-absorption of water by the kidneys (taking water back into the body).

  • Release of the hormone aldosterone which also causes water re-absorption by the kidneys.

Increasing the volume of the blood by adding more water and constricting your blood vessels increases blood pressure.

ACE inhibitors reduce the amount of angiotensin II which causes blood vessels to dilate. The amount of water put back into the blood by the kidneys decreases. These actions reduce blood pressure.

  • In high blood pressure (hypertension), ACE inhibitors should help to reduce the blood pressure.

  • In heart failure, there may be too much circulating fluid in the blood vessels. ACE inhibitors help to reduce this. They appear to have a protective effect on the heart and slow the progression of the heart failure.

People who should not take ACE inhibitors include:

  • Pregnant and breastfeeding women.

  • Those with a known sensitivity to ACE inhibitors.

  • Those who have had a severe allergic response to ACE inhibitors in the past - eg, swelling of the lips, eyes or tongue (angio-oedema).

  • People with certain types of kidney disease - for example, renal artery stenosis.

A full list of people who should not take ACE inhibitors is included with the leaflet that comes with your medicine. If you are prescribed ACE inhibitors, read this to be sure you are safe to take it.

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Side-effects of ACE inhibitors can include:

  • Baja presión arterial (hypotension).

  • Mareo.

  • Tos seca persistente.

  • Swelling of the lips, eyes or tongue (angio-oedema).

  • Decline in kidney function.

If you experience low blood pressure and dizziness you should report it to your doctor.

Nota: the above is not the full list of side-effects for these medicines. Please see the leaflet that comes with your particular brand for a full list of possible side-effects and cautions.

A number of medicines may interact with ACE inhibitors. In particular, medicamentos antiinflamatorios no esteroides (AINEs), 'water tablets' (diuretics) and lithium. Your doctor will normally check what other medicines you take and give further advice about this.

So, make sure your doctor knows of any other medicines that you are taking, including ones that you have bought rather than been prescribed.

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Preguntas frecuentes

Can ACE inhibitors be used for other heart problems besides high blood pressure and heart failure?

Yes, ACE inhibitors are also used after a heart attack (myocardial infarction) to help the heart recover and protect it.

If I am on an ACE inhibitor, will my blood pressure always be lower?

ACE inhibitors work to reduce blood pressure by dilating blood vessels and decreasing water re-absorption. While they generally lower blood pressure, a potential side-effect is low blood pressure (hypotension). If you experience symptoms like dizziness due to low blood pressure, you should inform your doctor.

How do ACE inhibitors help with kidney disease?

ACE inhibitors can help slow the progression of chronic kidney disease and maintain good kidney function in people with diabetic kidney disease (diabetic nephropathy).

How quickly do ACE inhibitors start working to lower blood pressure?

ACE inhibitors work by preventing the body from creating angiotensin II, which tightens blood vessels and causes water re-absorption. By reducing angiotensin II, blood vessels dilate and less water is put back into the blood, which reduces blood pressure. The article does not specify an exact timeframe for how quickly they start working, but it does state they 'usually work well to lower blood pressure'.

Are there different forms of ACE inhibitors, or are they all taken as single pills?

ACE inhibitors come in various brand names. Some are available as single medicines, while others are part of a combined tablet that also includes a calcium-channel blocker or a 'water tablet' (diuretic).

What should I do if I think an ACE inhibitor is causing a side effect?

If you experience any side effects, particularly low blood pressure and dizziness, you should report it to your doctor. Additionally, if you suspect a side-effect from any medicine, you can report it through the Yellow Card Scheme online at www.mhra.gov.uk/yellowcard. When reporting, it helps to have details about the side-effect, the medicine, and your contact information.

Lecturas adicionales y referencias

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About the authorView full bio

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Dra. Toni Hazell, MRCGP

MBBS, BSc, MRCGP, DFSRH, Dip GU med, DRCOG, DCH (London, UK, 2000)

Dr. Toni Hazell qualified from St. Mary’s Hospital Medical School and did her VTS at Northwick Park Hospital.

About the reviewerView full bio

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Dr Colin Tidy, MRCGP

Médico General, Autor Médico

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.

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