Certain types of ACE inhibitors may not be recommended for use in older adults. In general, older adults may be more sensitive to the effects of ACE inhibitors and therefore at higher risk of side effects. Dosages, therefore, tend to begin on the lower end of acceptable ranges for this population.

In addition, elderly patients are more likely to have impaired renal (kidney) function, which can increase the risk of hyperkalemia (too much potassium in the blood). Therefore, elderly patients may undergo blood or other testing to determine kidney function before being prescribed ACE inhibitors.