Which side effect is commonly associated with ACE inhibitors?

A persistent cough is commonly associated with ACE inhibitors due to the way these medications work. ACE inhibitors, or angiotensin-converting enzyme inhibitors, are used primarily to treat hypertension and heart failure by preventing the conversion of angiotensin I to angiotensin II, a peptide that narrows blood vessels and raises blood pressure.

When ACE is inhibited, there is an accumulation of bradykinin, which is a peptide that causes vasodilation (widening of blood vessels) but can also lead to increased sensitivity of nerve endings in the respiratory tract. This can trigger a dry cough that some patients may find bothersome. The mechanism of increased bradykinin levels is a key reason why this side effect occurs, and it is often significant enough for patients to need to switch to another class of medications if the cough becomes too troublesome.

Other options do not have the same established linkage with ACE inhibitors. Muscle cramps, dry mouth, and weight gain are not typical side effects associated with these medications, making the persistent cough the most characteristic and recognized adverse effect in patients on ACE inhibitor therapy.