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Angiotensin-converting-enzyme inhibitors (ACE inhibitors) are a class of medication used primarily for the treatment of high blood pressure and heart failure. [1] [2] This class of medicine works by causing relaxation of blood vessels as well as a decrease in blood volume, which leads to lower blood pressure and decreased oxygen demand from the heart.
BP >140/90: Two from different classes: preferably RAS-inhibitor (ACEI or ARB) with either thiazide diuretic/thiazide-like diuretic or dihydropyridine CCB. ESH 2023 [3] General age <65 General age 65–79 General age ≥80 <130/80 <140 SBP <150 SBP. BP <150/95: Lifestyle changes
There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers or antagonists (ARBs), and beta blockers.
Reflecting the critical role of zinc, ACE can be inhibited by metal-chelating agents. [14] ACE in complex with inhibitor lisinopril, zinc cation shown in grey, chloride anions in yellow. Based on PyMOL rendering of PDB 1o86. The picture shows that lisinopril is a competitive inhibitor, since it and angiotensin I are similar structurally.
It is a combination of lisinopril, an ACE inhibitor,with amlodipine, a calcium channel blocker. [1] It may be used when blood pressure is not well controlled with each of the two agents alone. [4] It is taken by mouth. [1] Side effects may include low blood pressure, kidney problems, liver problems, cough, and high blood potassium. [4]
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Lisinopril is an ACE inhibitor, meaning it blocks the actions of angiotensin-converting enzyme (ACE) in the renin–angiotensin–aldosterone system (RAAS), preventing angiotensin I from being converted to angiotensin II. Angiotensin II is a potent direct vasoconstrictor and a stimulator of aldosterone release.
[11] [12] [13] ACE inhibitors improve symptoms, decrease mortality and reduce ventricular hypertrophy. Angiotensin II receptor antagonist therapy (also referred to as AT 1 -antagonists or angiotensin receptor blockers), particularly using candesartan , is an acceptable alternative if the patient is unable to tolerate ACEI therapy.