The role of ACE inhibitors in cardiovascular disease

Abstract

Cardiovascular disease is the leading cause of death in the UK, with heart failure and ischaemic heart disease the commonest forms of the condition. The renin–angiotensin–aldosterone system is recognised as having an integral pathophysiological role by increasing afterload, promoting sodium and water retention and contributing to ventricular remodelling. Evidence from randomised controlled trials has demonstrated that angiotensin-converting enzyme (ACE) inhibitors reduce mortality, slow disease progression and reduce left ventricular workload. This is achieved by inhibiting the conversion of angiotensin I to angiotensin II. Preload and afterload are reduced, which preserves left ventricular function. Common adverse effects include cough, hypotension, hyperkalaemia and a decline in renal function. The nurses' role in caring for patients receiving ACE inhibitor therapy includes clinical assessment, monitoring and detecting adverse effects as well as patient education.