What is a common side effect of ACE inhibitors?

A common side effect of ACE inhibitors is a dry hacking cough. This occurs due to the accumulation of bradykinin, a peptide that is elevated because ACE inhibitors block the angiotensin-converting enzyme responsible for breaking down bradykinin. When levels of bradykinin rise, it can lead to this persistent cough in some patients, which may develop after a few weeks of therapy and can be bothersome enough to require discontinuation of the medication in certain cases.

Other side effects commonly reported with ACE inhibitors include the ones listed, but they do not have the same strong association as the cough. Headaches can occur but are not as distinctive or prevalent; nausea and skin rashes are also potential side effects but are less commonly associated with this class of drugs. Thus, the dry cough remains the hallmark side effect that clinicians often discuss with patients starting on ACE inhibitors.