What common adverse effect do ACE inhibitors cause due to their mechanism of action?

ACE inhibitors, or angiotensin-converting enzyme inhibitors, are commonly prescribed medications used primarily for managing hypertension and heart failure. One of the well-known adverse effects associated with ACE inhibitors is a persistent, often bothersome cough. This cough results from the accumulation of bradykinin, a peptide that is normally broken down by the enzyme that ACE inhibitors inhibit. When this enzyme is blocked, bradykinin levels rise, leading to increased stimulation of the cough reflex.

Other potential adverse effects are more rare, and while they may be related to respiratory issues, they do not manifest as a chronic cough. For instance, spontaneous pneumothorax and pneumonia are not directly linked to the action of ACE inhibitors, nor is respiratory depression, which involves a decrease in the rate or effort of breathing. These conditions do not share the same pathophysiological mechanisms as the cough caused by increased bradykinin levels, making the unrelenting cough the most characteristic and common side effect in patients taking ACE inhibitors. Understanding this side effect is crucial for healthcare providers when educating patients about what to expect while on these medications.