ISSN 2398-2950      

ACE inhibitors: overview

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Synonym(s): Angiotensin converting enzyme inhibitors


Action

  • Angiotensin-converting enzyme (ACE) inhibitors inhibit ACE (present in the endothelia of the small blood vessels of the lungs, kidneys and other tissues).
  • ACE converts angiotensin I (a precursor molecule which is mainly inactive) to the hormone angiotensin II.
  • ACE catalyses breakdown of bradykinin.
  • Angiotensin II has several effects:
    • Contraction of vascular smooth muscle, producing vasoconstriction.
    • Stimulation of aldosterone secretion from the adrenal cortex.
    • Increased sodium reabsorption proximal renal tubuli.
    • Stimulation of hypertrophy of the myocardium and vascular smooth muscle.
    • Stimulation of thirst receptors in the brain.
    • Enhanced sympathetic adrenergic tone and increased release of noradrenaline from sympathetic nerve terminals.
    • Increases endothelin release, which might cause vasoconstriction.
    • Stimulation of vasopressin (antidiuretic hormone) release from posterior pituitary gland.

Effects

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ACE Inhibitors available and their use in cats

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Ramipril

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ACE inhibitors and renal function

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Use of diuretics with ACE inhibitors

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • MacDonald K, Kittleson M D, Larson R F et al (2006) The effect of Rampril on left ventricular mass, myocardial fibrosis, diastolic function, and plasma neurohormones in Maine Coon cats with familial hypertrophic cardiomyopathy without heart failureJVIM 20 (5), 1093-1105 PubMed.
  • Sturgess K (2004) The role of ACE inhibitors in the management of acquired heart disease in cats. UK Vet 9, 51-60.
  • Davidson G, Horeish C (1999) Enalapril maleate. Comp Contin Educ Pract Vet 21 (12), 1118-1121 VetMedResource.
  • Boswood A (1998) Rationale for the use of drugs in the treatment of cardiovascular disease. 2. Vasodilators. In Practice 20 (2), 55-63 VetMedResource.
  • Rush J E, Freeman L M, Brown D J et al (1998) The use of enalapril in the treatment of feline hypertrophic cardiomyopathy. JAAHA 34 (1), 38-41 PubMed.
  • Boswood A (1996) Rationale for the use of drugs in the treatment of cardiovascular disease. 1. Diuretics. In Practice 18 (10), 469-476 VetMedResource.

Other sources of information

  • Bishop Y M (1996) Ed The Veterinary Formulary. Handbook of Medicines used in Veterinary Practice. 3rd edn. London: Royal Pharmaceutical Society of Great Britain and British Veterinary Association. pp 201-202. ISBN 0 85369 345 5.
  • Wotton P R & Gruffydd-Jones T J (1994) The cardiovascular system. In: Feline Medicine and Therapeutics. 2nd edn. Eds E A Chandler, C J Gaskell & R M Gaskell. Oxford: Blackwell Scientific Publications. pp 412-413. ISBN 0 632 03361 4.

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