4010F Angiotensin Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) therapy prescribed or currently being taken (CAD, CKD, HF) (DM)

Name of the Procedure:

Angiotensin Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy

Summary

ACE Inhibitor or ARB therapy involves taking medication to help relax blood vessels, lower blood pressure, and reduce the strain on the heart. These medications are often prescribed for conditions such as coronary artery disease (CAD), chronic kidney disease (CKD), heart failure (HF), and diabetes mellitus (DM).

Purpose

The primary purpose of this therapy is to manage high blood pressure and reduce the risk of heart attacks, strokes, and kidney damage. It is also used to improve heart function and prevent complications in patients with heart failure.

Indications

• High blood pressure (Hypertension)
• Coronary Artery Disease (CAD)
• Chronic Kidney Disease (CKD)
• Heart Failure (HF)
• Diabetes Mellitus (DM)

Preparation

• No specific preparation is generally required.
• Blood pressure and kidney function tests (serum creatinine and electrolytes) may be conducted to establish a baseline.

Procedure Description

• Step 1: The healthcare provider prescribes an ACE inhibitor (like Lisinopril) or an ARB (like Losartan).
• Step 2: The patient takes the medication as directed, usually once daily.
• Step 3: Regular monitoring of blood pressure and kidney function through follow-up appointments.

Duration

• Ongoing, typically a lifelong commitment to manage chronic conditions.

Setting

• Prescribed and monitored in an outpatient setting such as a doctor's office or clinic.

Personnel

• Managed by a family physician, internist, or cardiologist.
• Possibly involving nurses for regular follow-up and monitoring.

Risks and Complications

• Common: Cough (ACE inhibitors), dizziness, elevated blood potassium levels.
• Rare: Angioedema (swelling of deeper layers of the skin), kidney dysfunction, low blood pressure.

Benefits

• Lower blood pressure.
• Improved heart function in heart failure patients.
• Reduced risk of stroke, heart attack, and kidney damage.
• Positive effects may be noticed within a few weeks of starting therapy.

Recovery

• Not a traditional recovery but rather regular monitoring.
• Adherence to medication and follow-up visits are crucial.
• Lifestyle changes such as a healthy diet and exercise may be recommended.

Alternatives

• Other antihypertensive medications (e.g., beta-blockers, calcium channel blockers).
• Pros: Alternative medications might be used if a patient cannot tolerate ACE inhibitors or ARBs.
• Cons: May not provide the same level of kidney protection in diabetic patients.

Patient Experience

• Generally well-tolerated.
• Patients might experience mild side effects like dizziness, but these often improve over time.
• Pain management is not typically necessary, but managing side effects is important.