ACE inhibitors/ARBs in Heart Failure

ACE inhibitors are angiotensin converting enzyme inhibitors and ARBs are angiotensin receptor to blocker drugs. Both of those have been used for around 30 to 40 years in patients with heart failure and have a long history of showing beneficial effects in patients to reduce their heart failure hospitalisations, reduce heart failure mortality and improve ejection fraction. They are one of the key pillars of heart failure treatment. We tend to give people eight inhibitors to begin with and if they suffer with a side effects such as a cough, we'll swap them on to an angiotensin receptor blocker. They can sometimes lower the blood pressure, so again if you feel lightheaded after starting an ACE or an ARB drug, then have a discussion with your doctor, as it may be that the dose is too high. Most people will tolerate it and it may be the case that it just needs to be tweaked down, but if you do have any concerns then do speak to your doctor.