ACE Inhibitors

Treatment of essential Htn, CHF, and mitral regurgitation.

Numerous studies show that ACE-I use improves symptoms and quality of life, as well as reduces mortality rate in elderly with heart failure and decreased LVEF.

Decreases mortality after myocardial infarction.

Safe and effective treatment of Htn in diabetics; strong evidence that ACE-I delays the progression of diabetic renal disease.

Severe and prolonged hypotension in pts undergoing general anesthesia

May increase insulin sensitivity and hypoglycemia in diabetics

Conflicting evidence regarding risk of AKI

Decreased GFR and not recommended in pts with renal artery stenosis.

Life-threatening angioedema involves the swelling of head, neck, and tongue.

Hyperkalemia because of decreased production of aldosterone.

Fetal anomalies and fetal and neonatal death.