Читать книгу High Blood Pressure: Natural Self-help for Hypertension, including 60 recipes - Michelle Berriedale-Johnson - Страница 36

ACE inhibitor drugs are so-named because they block formation of Angiotensin Converting Enzyme (ACE). This in turn prevents formation of a substance called angiotensin II – a powerful constrictor of blood vessels – leading to dilation of both small arteries and veins. This reduces total peripheral resistance and arterial blood pressure. ACE inhibitors also increase blood flow to the kidneys, so more fluid and sodium is lost as urine. They are usually considered for treating hypertension when thiazides diuretics or beta-blockers are contraindicated, not tolerated, or fail to control high blood pressure.

They can cause a sudden fall in BP on giving the first dose, especially in people who are taking diuretics or who are dehydrated. Where possible, diuretic treatment is therefore usually stopped a few days before ACE inhibitor treatment is started. For some, the first dose is best taken at night on retiring to bed. Kidney function and salt balance should be checked before treatment is started. ACE inhibitors may be less effective in people of Afro-Caribbean descent unless combined with a thiazide diuretic.