Ace inhibitors

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The angiotensin-converting enzyme (ACE) inhibitors are a widely used class of antihypertensive medications that act by blocking the conversion of angiotensin I to angiotensin II, thus inhibiting an intermediate step in the renin-angiotensin pathway.

Clinical use in high blood pressure

The ACE inhibitors are considered first line drugs for the therapy of hypertension and are considered particularly helpful in preventing the renal complications of diabetes and high blood pressure.

Liver toxicity of Ace inhibitors

The ACE inhibitors are rare causes of clinically apparent liver injury. All of the currently used ACE inhibitors are associated with a low rate of serum enzyme elevations during chronic therapy (0.2% to 2%) which is minimally different from the rate of elevations during placebo therapy. The aminotransferase elevations are usually mild-to-moderate in severity, self limited, and rarely require dose modification or drug discontinuation.

Mechanism of action of Ace inhibitors

The ACE inhibitors act by blocking the conversion of angiotensin I to angiotensin II, the active peptide that causes the vasoconstriction and sodium retention induced by activation of the renin-angiotensin pathway. The angiotensin-converting enzyme (ACE) inhibitors are a widely used class of antihypertensive medications that act by blocking the conversion of angiotensin I to angiotensin II, thus inhibiting an intermediate step in the renin-angiotensin pathway.

The ACE inhibitors act by blocking the conversion of angiotensin I to angiotensin II, the active peptide that causes the vasoconstriction and sodium retention induced by activation of the renin-angiotensin pathway. The ACE inhibitors are considered first line drugs for the therapy of hypertension and are considered particularly helpful in preventing the renal complications of diabetes and high blood pressure.

Other uses for Ace inhibitors

ACE inhibitors are sometimes used even in patients with relatively normal blood pressure for treatment of heart failure and prevention of diabetic neuropathy.

Currently, there are 10 ACE inhibitors approved for use in the United States: captopril (Capoten: 1981), enalapril (Vasotec: 1985), lisinopril (Prinivil, Zestril: 1987), benazepril (Lotensin: 1991), fosinopril (Monopril: 1991), quinapril (Accupril: 1991), ramipril (Altase: 1991), perindopril (Aceon: 1993), moexipril (Univasc: 1995), and trandolapril (Mavik: 1996).

Common ACE inhibitors include the following:

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