ACE Inhibitors: Patient Selection, Initiation, Titration

Prescribing an ACE inhibitor is a sequence of decisions: whether this patient should receive one, which agent, at what starting dose, monitored how often, and what to do when creatinine or potassium moves. That sequence, including the adverse-effect management that preserves a therapy with outcome benefit rather than abandoning it. By the end you should be able to: - Determine whether an ACE inhibitor is appropriate for a specific patient and indication. - Exclude absolute contraindications and quantify precautions before initiation. - Select an agent and construct an initiation, titration and monitoring plan individualized to the patient. - Distinguish expected hemodynamic change from clinically important deterioration in creatinine and potassium. - Manage cough, angioedema, hypotension, renal deterioration and interactions without reflexively abandoning a therapy with outcome benefit.