• High blood pressure (hypertension). A condition in which blood is pumped with excessive force against the artery walls. ACE inhibitors cause blood vessels to relax, or widen, reducing blood pressure. They may be used alone or in combination with other antihypertensives (e.g., beta blockers, A-II blockers, calcium channel blockers) or diuretics. Research has found that low doses of two or three blood pressure-lowering medications can be effective in treating high blood pressure.

  • Heart failure. A condition in which one or more of the heart’s chambers is not pumping well enough to meet the body’s demands, leading to fluid in the lungs and shortness of breath. ACE inhibitors are often given in combination with beta blockers to reduce the workload on the heart and slow the progression of the heart failure. ACE inhibitors may also improve survival rates in patients with weak hearts, whether or not they have heart failure.

  • Heart attack. An event that results in permanent heart damage or death. A heart attack occurs when one of the coronary arteries becomes severely or totally blocked, usually by a blood clot. When the heart muscle does not obtain the oxygen-rich blood that it needs, it will begin to die. When given shortly after a heart attack, certain ACE inhibitors may prevent some of the damage to the heart and improve the survival rate of heart attack patients.
    A heart attack happens every 29 seconds and is usually due to coronary artery disease (CAD).
    Also, recent research has shown that, when used in combination with other proven therapies (e.g., anticoagulants, beta blockers and statins), ACE inhibitors may increase survival rates for patients after a heart attack or other acute coronary event.

  • Coronary artery disease. A condition in which one or more of the blood vessels supplying the heart muscle (coronary arteries) becomes narrowed due to a buildup of plaque (atherosclerosis). There is increasing evidence to suggest that patients with coronary artery disease may benefit from the use of ACE inhibitors even before a coronary event, such as a heart attack, occurs. In addition, ACE inhibitor use in patients undergoing bypass surgery may help decrease the risk of developing atrial fibrillation following surgery.

  • Diabetes. A metabolic condition in which the body cannot properly absorb blood sugar (glucose) because of a lack of, or inability to use, insulin. As a result, glucose levels can rise to dangerously high levels in the bloodstream, which can lead to complications such as kidney damage and increased risk of heart disease. Large studies have shown that ACE inhibitors were able to reduce the risk of developing diabetes. This is a relatively major finding because other blood pressure medications, such as diuretics, are known to cause diabetes at higher doses.

    Certain ACE inhibitors (e.g., captopril) have been found to slow the process that leads to kidney damage, or renal insufficiency, in many patients with type 2 diabetes, as well as increase insulin sensitivity. Research has indicated that ACE inhibitors may even improve survival rates in diabetes patients without heart disease. While ACE inhibitor use following a heart attack has been found to be beneficial in general, people with diabetes may benefit even more from these medications than patients without blood sugar problems. Unfortunately, recent research indicates that a significant percentage of people with diabetes (up to 57 percent) are not taking ACE inhibitors. 

  • Kidney disease. ACE inhibitors are beneficial for certain types of kidney disease (e.g., proteinuria). Research has shown particular benefit of ACE inhibitors in reducing the progression of kidney disease in black Americans, which is most often caused by high blood pressure. Although a few newer studies have called into question the efficacy of ACE inhibitors in preventing Heart attack when compared to diuretics, these drugs are still effective and widely prescribed.  

  • Lower extremity PAD. A type of peripheral arterial disease (PAD) in which one or more of the blood vessels supplying the legs become narrowed due to atherosclerosis. Research has indicated that patients taking ACE inhibitors prior to a peripheral bypass operation have increased survival rates after the operation.