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Frank Son, PharmD

Vegan-Friendly High Blood Pressure Medications (ACE Inhibitors & ARBs)

Updated: Mar 21

Hypertension is the leading risk factor for cardiovascular disease, the main cause of global mortality. Angiotensin-Converting Enzyme (ACE) inhibitors and Angiotensin II Receptor Blockers (ARBs) are first-line treatment options for the treatment of high blood pressure. We at VeganMed have verified 1 animal-free ACE inhibitor and 1 animal-free ARB!


Suboptimal blood pressure control is a common attribute of:

  1. Cardiovascular Disease:

    1. 55% of ischemic heart disease

    2. 58% of other cardiovascular diseases (heart failure, peripheral arterial disease)

  2. Cerebrovascular disease:

    1. 58% of hemorrhagic strokes

    2. 50% of ischemic strokes

  3. Kidney function decline


What is Hypertension?

Normal blood pressure is categorized by a systolic pressure (pumping pressure) below 120 mm Hg and a diastolic pressure (filling pressure) below 80 mm Hg. Hypertension is diagnosed when blood pressure is consistently measured with a systolic reading greater than or equal to 130 and/or a diastolic reading greater than or equal to 80 mm Hg.

American Heart Association (AHA) Blood Pressure Categories

Treatment of Hypertension

It is important to note that the treatment of hypertension should involve lifestyle modifications in addition to blood pressure-lowering medications such as ACE inhibitors and ARBs.


Lifestyle Modifications

  • Dietary Salt Restriction

  • Weight Loss

  • Dietary Approaches to Stop Hypertension (DASH) diet: a diet high in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish, nuts, and low in sweets, and red meats.

  • Regular Exercise

  • Decrease Alcohol Intake

  • Smoking cessation

Renin-Angiotensin-Aldosterone System

Kidney Protection from ACEIs and ARBs

ACE inhibitors and ARBs decrease blood pressure by relaxing blood vessels. This vascular relaxation decreases the pressure in the blood vessels of the kidneys, improving blood flow and kidney function. ACE inhibitors and ARBs also help to prevent protein from leaking into urine and improve sodium excretion, aiding normal kidney function. These kidney protective effects are notably beneficial in patients with congestive heart failure and diabetes.


Possible Side Effects of ACE Inhibitors and ARBs

  • Cough (ACE inhibitors only)

  • Hyperkalemia: High Potassium Levels

  • Angioedema: Swelling beneath the skin's surface, typically appearing around the face, lips, tongue, throat, or extremities

Avoid ACE Inhibitors and ARBs in Pregnancy

According to the American Heart Association (AHA), the use of ACE inhibitors and ARBs is not recommended in pregnant women as the medications may cause fetal harm. Complications include fetal kidney impairment, oligohydramnios, and death. Studies show that these complications occurred more frequently when ACE inhibitors or ARBs were used during the second and third trimester or the entire pregnancy.


Conclusion

Although 4 of 5 brand name ACE inhibitors and 5 of 6 brand name ARBs researched contain animal-derived ingredients, we do not discourage the use of potentially life-saving medications which may not be animal-free. The adoption of a vegan or vegetarian diet can help lower blood pressure.

Animal-Free Angiotensin-Converting Enzyme (ACE) Inhibitors
Animal-Free Angiotensin II Receptor Blockers (ARB)

*As of 2024, Diovan has been changed to "Unknown" regarding its animal-free status. The term “Unknown” is used for products when manufacturers claim the product is animal-free, but they disclose they haven’t done additional testing to be absolutely certain that it doesn’t contain any animal-derived ingredients. The “Unknown” status is there to give consumers the information they need to make an informed decision and decide whether they want to use that particular product.


To ensure products contain no animal-derived ingredients or by-products, we have either certified or verified each product on our online marketplace and blog posts. For product verification, we conduct independent research and collaborate with manufacturers to confirm the source of each active and inactive ingredient. Certified products undergo pharmacist ingredient reviews similar to product verification, but also inspection of the manufacturing process and laboratory testing for animal derivatives.


Co-authored by: Inderveer Chahal, Aurash Nicholas Sadeghi, Onel Isha, Hae Ji Shin


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Disclaimer: The product and/or medical information provided on VeganMed is of a general nature and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or product.

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Thank you for your awareness and concern for animal-derived ingredients!


If you have any further questions about ingredients in your medicines and supplements, feel free to reach out to the VeganMed team!





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