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From Citizendium, the Citizens' Compendium

Angiotensin-converting enzyme inhibitors (commonly ACE inhibitors) are a "class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility.^[1]

Angiotensin-converting enzyme inhibitors also decrease the degradation of bradykinin as the enzyme kininase II is the same enzyme as angiotensin-converting enzyme.^[2] This may contribute to some patients having a cough when taking angiotensin-converting enzyme inhibitors. According to a clinical prediction rule, cough due to angiotensin-converting enzyme inhibitors is more likely among patients who are "older age, female gender, non-African American (with East Asian having highest risk), no history of previous angiotensin-converting enzyme inhibitor use, and history of cough due to another angiotensin-converting enzyme inhibitor".^[3]

References

1. ↑ Anonymous, (2008) Angiotensin-converting enzyme inhibitors (English). Medical Subject Headings. U.S. National Library of Medicine.
2. ↑ Gainer JV, Morrow JD, Loveland A, King DJ, Brown NJ (October 1998). "Effect of bradykinin-receptor blockade on the response to angiotensin-converting-enzyme inhibitor in normotensive and hypertensive subjects". N. Engl. J. Med. 339 (18): 1285–92. PMID 9791144.
3. ↑ Morimoto T, Gandhi TK, Fiskio JM, et al (June 2004). "Development and validation of a clinical prediction rule for angiotensin-converting enzyme inhibitor-induced cough". J Gen Intern Med 19 (6): 684–91. DOI:10.1111/j.1525-1497.2004.30016.x. PMID 15209608.