What is the most common side effect associated with ACE inhibitors?

The most common side effect associated with ACE inhibitors is a cough. This is attributed to the accumulation of bradykinin, a peptide that is normally broken down by angiotensin-converting enzyme (ACE). When ACE inhibitors block this enzyme, bradykinin levels increase, which can lead to a persistent dry cough in some patients. This side effect is significant enough that it may prompt clinicians to switch patients to an alternative antihypertensive medication, such as an angiotensin receptor blocker (ARB), which does not have the same effect on bradykinin metabolism. Understanding this can help clinicians manage potential side effects effectively while treating patients with ACE inhibitors.