ACE Inhibitors

ACE inhibitors are used for control of your blood pressure or heart disease. This category of drug
requires periodic evaluation of laboratory parameters. You may need labs for BUN, creatinine, and CBC
at 2, 4 and 8 weeks and then every six months. In addition you should have your blood pressure checked
in 2 weeks.
We are now monitoring blood pressures less frequently after a change in medication dosage. You may
notice some minor symptoms the first week. These frequently improve if the drug is continued. Some
medications also have a prolonged onset of a maximum effectiveness. This medication can be increased
to achieve a blood pressure goal of 135/85. (If you are diabetic, the goal is 125/80). Please see your
primary care physician to follow through on these laboratory and blood pressure recommendations. Your
cooperation is essential in coordinating the maximum medical care for yourself.
In addition to
medications, the optimal management for hypertension is best achieved with a low sodium diet, regular
exercise, weight loss and avoiding alcohol excess.
This same medication is utilized in congestive heart failure where it can improve the function of the heart.
In diabetes, it can reduce complications in almost every organ system, especially the kidneys. When
used for heart failure or diabetes, the medication is started even if you already have a normal blood
In the treatment of congestive heart failure, there is a “target” dose, which seems to be most beneficial.
Usually the dose is begun at a low level and then gradually increased to the target goal. Suggestions for
this goal are:
Lotensin 10 mg bid (twice a day)
Capoten 50 mg tid (three times a day)
Vasotec 10 mg bid (twice a day)
Monopril 20 mg daily
Zestril/Prinivil 10-20 mg daily
Univasc 7.5 mg bid (twice a day)
Accupril 20 mg bid (twice a day)
Altace 5 mg bid (twice a day)
Mavik 4 mg daily
DCC, December 2007