What is the major side effect associated with ACE inhibitors?

Cough is indeed a well-known major side effect associated with ACE inhibitors. This occurs due to the accumulation of bradykinin, a peptide that is normally broken down by angiotensin-converting enzyme (ACE). When ACE is inhibited, bradykinin levels rise, which is primarily responsible for the persistent dry cough that some patients experience.

While other side effects such as hyperkalemia, angioedema, and renal failure can occur, the cough is particularly notable because it affects a significant number of patients using ACE inhibitors—estimates suggest that between 5% to 20% may develop this side effect. Many patients have to discontinue their medication due to the cough, making it a critical consideration in their management. Understanding this side effect helps healthcare providers monitor their patients and choose alternative medications if necessary, while still addressing their cardiovascular conditions.