Vignette: A 25-year-old woman presents to her primary care physician for her annual physical. She is generally in good health but has a family history of hypertension and is concerned about developing it herself. Her blood pressure at today's visit is 135/85 mm Hg. Her physician tells her that it's important to maintain a healthy diet, regular physical activity, and avoid smoking to help prevent hypertension. In addition, he tells her that if she were to develop hypertension, he could prescribe a medication that works by inhibiting the angiotensin-converting enzyme (ACE) in the body.
Question: Which of the following adverse effects is most likely to be seen with an ACE inhibitor?
ACE inhibitors, such as lisinopril and captopril, are commonly used in the management of hypertension. They work by inhibiting the conversion of angiotensin I to angiotensin II, thereby reducing the vasoconstrictive and aldosterone-secreting effects of angiotensin II. As a result, ACE inhibitors reduce systemic vascular resistance and decrease sodium and water reabsorption in the kidneys, lowering blood pressure. However, because aldosterone also plays a role in potassium excretion in the kidneys, ACE inhibitors can lead to reduced potassium excretion and thus hyperkalemia. This is why monitoring of serum potassium levels is recommended in patients taking ACE inhibitors. The other choices are not typically associated with ACE inhibitors.