• Tuesday February 18,2020

ACE inhibitors

In hypertension, the focus of medical treatment and therapy is ACE inhibitors. The abbreviation ACE stands for angiotensin-converting enzymes, to german angiotensin-converting enzyme. ACE inhibitors are used as medicines to regulate the water-electrolyte balance and maintain and stabilize blood pressure.

What are ACE inhibitors?

ACE inhibitors are used as medicines to regulate the water-electrolyte balance and maintain and stabilize blood pressure.

ACE inhibitors are a class of antihypertensive drugs. The mechanism of action is an intervention in the hormonal system. The abbreviation "ACE" stands for "angiotensin converting enzyme" or in English: angiotensin converting enzyme.

This is an enzyme that, like any of these proteins, causes a specific material transformation in the organism. By inhibiting an enzyme, a chain reaction in the living body can be interrupted. Hereby physiological processes can be specifically influenced. ACE converts the precursor (prohormone) of the hormone angiotensin into its active form. This activated messenger causes a contraction of the vessels and thus a blood pressure increase.

If the activation is suppressed, this leads to a blood pressure reduction. ACE inhibitors block the ACE, which causes this activation. As a result, this has a blood pressure reduction via the pathway of reducing the angiotensin level by the ACE inhibitor.

Application, effect & use

ACE inhibitors relieve the cardiovascular system by lowering blood pressure. Thus, these antihypertensives prevent serious diseases of the vessels and the heart. Application is therefore the essential hypertension, a form of chronic hypertension with unknown cause.

The aim of the medication is to avoid stroke and heart attack. However, ACE inhibitors are also used for relapse prevention after such acute diseases have been overcome. Even in the course of acute myocarditis is often a medication with ACE inhibitors, so that the hollow muscle undergoes effective relief. Another indication is mild to moderate heart failure (heart failure).

The chronic disease requires persistence of antihypertensive drugs, mostly from the group of ACE inhibitors. Another area of ​​application is the prevention of kidney damage in diabetics. High blood pressure in this patient group often causes scarring in the microfine structures of the excretory organ.

The doctor often combines ACE inhibitors with other antihypertensives. Dehydrating medications (diuretics) and agents that work via the calcium metabolism of the vessel walls have proven to be effective. A positive side effect of ACE inhibitors is a promotion of cell regeneration in the vessels. This is probably due to the inhibition of arteriosclerosis. In the context of coronary heart disease, this effect proves to be therapeutically very favorable and is an argument for the use of ACE inhibitors.

Herbal, Natural & Pharmaceutical ACE Inhibitors

ACE inhibitor of the first hour was a snake venom. First, a substance was isolated from the venom of the South American Lance Otter, on which the enzyme inhibition was experimentally detected.

Thereafter, synthetic analogues were developed, which eventually became suitable for medication. Today there are more than 10 different synthetic substances contained in available drugs. Most of the active ingredients are precursors of the actual drug. The reason for this is that the pharmaceuticals are absorbed more efficiently in this form. Only in the metabolism, the active ingredient is split off.

This effective ingredient is just a remnant of the original snake venom. The pharmaceutical utility results from the connection with different carrier substances. Depending on the preparation, it is for example succinic acid or glutaric acid, which ensures the chemical stability of the active substance in a modified form.

Since ACE inhibitors are often co-administered with other antihypertensives, there are many combination preparations with ACE inhibitors on the market.

Risks & Side Effects

ACE inhibitors have side effects that are mostly attributed to an effect. The angiotensin converting enzyme has a second metabolic function: it breaks down the tissue hormone bradykinin. Under the influence of an ACE inhibitor increases the bradykinin levels and causes in complex sequelae some undesirable symptoms.

Patients often complain of severe coughing and rash during ACE inhibitor medication. These "exanthemas" almost always take on large-scale proportions. The potassium level may be increased while the sodium concentration is lowered. Renal dysfunction that may develop into acute kidney failure is rare. Occasionally, water retention of the subcutaneous tissue (edema) and asthmatic incidents are observed.

In addition, it can lead to the reduction of platelets (platelets, cells with blood clotting function), in parallel, the leukocytes (white blood cells) are reduced. The erythrocytes (red blood cells) can be increasingly broken down, which can lead to anemia ("anemia"). In addition, cases of hepatic impairment have been described. Rarely, there is dreaded anaphylactic shock due to medication with an ACE inhibitor.

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