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afya ACEinhibitors

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20160425222446 Ben  
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Used for younger HT (not so good in afro-carribeans)
in heart failure, diabetic nephropathy and 2ndary prevent IHD
inhibit conversion of angiotensin 1 to 2

''SE'' (ACEi (E becomes H))
Angioedema (up to 1 yr)
Cough - 15% for up to 1yr (?due to bradykinin increase) 
Hypotension esp if also on diuretics (loop) or AS (Ist dose)
Inc K - Hyperkalaemia

''Cautions / CI''
Avoid in pregnancy and breast feeding
renal impairment if bilateral renal artery stenosis
aortic stenosis (causes hypotension)
high dose diuretic (fruse 80) inc risk hypotension
herediatary idiopathic angioedema

''Monitour''
U/E - at start and if inc dose
rise of 30% from baseline creatinine (25% fall in eGFR) and up to 5.5 K are acceptable - NICE