Mechanism of Action1

ACE Inhibitors decrease blood pressure by inhibiting the Angiotensin-Converting Enzyme. This inhibition lowers blood pressure two ways.

One mechanism blocks the conversion of angiotensin I to angiotensin II resulting in decreased peripheral vascular resistance and decreased sodium and water retention.

The other mechanism blocks the degradation of bradykinin to lower blood pressure by decreasing peripheral vascular resistance.

Indications for Use:

  • Hypertension (High blood pressure)
  • Heart failure
  • Left Ventricular Dysfunction
  • Diabetic Nephropathy (Diabetic kidney disease)

Note: The above FDA approved indications vary among members of the ACE inhibitor drug class.

Common Adverse Effects

  • Hypotension (Low Blood Pressure)
  • Decreased Kidney Function
  • Hyperkalemia (High Blood Potassium)
  • Cough
  • Anemia (low red blood cell count)
  • Angioedema

Avoid Use in the Following Populations

  • Pregnant women
  • Women not using contraception2

Fitness Related Physiological Effects

Physiologic FactorEffect
Heart RateSlight Increase2
Blood pressureDecrease1
Cardiac OutputIncrease2
Stroke VolumeIncrease2
Vascular ResistanceDecrease1
Plasma VolumeNo Effect2
EnduranceNo Effect2

List of ACE Inhibitors

  • Benazepril (Lotensin)
  • Captopril (Capopten)
  • Enalapril (Epaned, Vasotec)
  • Fosinopril (Monopril)
  • Lisinopril (Prinivil, Qbrelis, Zestril)
  • Moexipril (Univasc)
  • Perindopril (Aceon)
  • Quinapril (Accupril)
  • Ramipril (Altace)
  • Trendolapril (Mavik)


  1. Katzung, B., & Trevor, A. J. (2015). Basic and clinical pharmacology (13E). New York: Mcgraw-Hill.
  2. Niedfeldt, MW. Managing Hypertension in Athletes and Physically Active Patients. American Family Physician 2002; 66(3):445-452.