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How does an ACE Inhibitor work? ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance that affects your cardiovascular system by narrowing your blood vessels and releasing hormones that can raise your blood pressure. This narrowing can cause high blood pressure and force your heart to work harder. ACE inhibitors also increase blood flow, which helps to decrease the amount of work your heart has to do and can help protect your kidneys from the effects of hypertension (high blood pressure).
ACE inhibitors affect the renin-angiotensin-aldosterone system and block the conversion of angiotensin I to angiotensin II, which is involved in vasoconstriction. ACE inhibitors are associated with a dry, persistent cough in 5%-35% of patients who take them. The mechanism of cough is likely multifactorial. ACE inhibitors prevent the breakdown of bradykinin and substance P, resulting in an accumulation of these protussive mediators in the respiratory tract.