Medically Approved

What to eat (and avoid) while taking an ACE inhibitor

Image of heart-healthy foods

A heart-healthy diet can help you get the most out of your medication.

Colleen Stinchcombe

By Colleen Stinchcombe

Your heart-health plan should include more than just medication. If you’re taking an ACE inhibitor, odds are you have special dietary needs that you should be thinking about every time you fill your plate.

Originally, ACE inhibitors were prescribed to treat high blood pressure, or hypertension, exclusively. They work by blocking a complex protein called an angiotensin-converting enzyme (ACE), which constricts blood vessels. With less ACE, your blood vessels are able to relax, and blood flows more easily.

But the medication proved to be so effective that it’s now used for a wider range of heart-related issues. “The most common uses include the treatment of hypertension, coronary artery disease, and certain types of heart failure and kidney disease,” says Dmitry Abramov, MD. He’s a cardiologist at Loma Linda University Health in California.

Common ACE inhibitors include benazapril (Lotensin®) and enalapril (Vasotec®). If you’re on one of these medications, your doctor is likely concerned about your heart health. (Click here to search for coupons for other ACE inhibitors.) That means that in addition to following your prescriber’s orders, you should be careful about what you eat.

“Most patients taking an ACE inhibitor should be on a heart-healthy diet,” Dr. Abramov says. In fact, diet and other lifestyle changes may even reduce your reliance on medication. “Less salt intake, less alcohol intake, more exercise and weight loss can sometimes lead to a reduction in blood pressure so medications such as ACE inhibitors may no longer be needed,” he says.

In the meantime, Optum Perks can help. Our free discount card is accepted at more than 64,000 U.S. pharmacies, and it may save you money on your prescription medication.

But even if you aren’t able to kick your ACE inhibitors, eating well can help you manage your condition and live a long, healthy life. Sound like good motivation? Let’s get started.

ACE-inhibitor diet: What to eat

More than 20 years ago, the National Institutes of Health developed a diet specifically for heart health. It’s called Dietary Approaches to Stop Hypertension (DASH). Many fad diets have cropped up in recent years, but U.S. News & World Report still considers DASH to be one of the best eating plans, even for people without hypertension.

You can learn more about the DASH diet here. But to follow it, you’ll generally want to focus on these foods:

  • Fruits
  • Vegetables
  • Nuts
  • Low-fat dairy products
  • Fish
  • Poultry
  • Some whole grains

And what you’ll want to avoid is sodium. DASH limits salt in recipes and suggests monitoring sodium in packaged foods. “I’ll tell patients, ‘Throw out your salt shaker,’” says Dana Ellis Hunnes, PhD. She’s a clinical dietitian at the Ronald Reagan UCLA Medical Center and the author of Recipe for Survival.

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ACE inhibitor diet: What to avoid

Sodium, the mineral in salt, is a big problem for people with hypertension. So Hunnes suggests keeping your intake below 2,000 milligrams (mg) per day. Some patients with especially high blood pressure should aim for 1,500 mg or less.

That means that if you’re eating 3 meals a day, each one should contain 500 mg of sodium or less. For snacks, “I encourage people to look for things with less than 100 mg of sodium,” says Hunnes. Don’t be surprised if that feels hard at first. “When we’re telling people to cut back on sodium, it’s really a huge change for their palates,” she says. But once you adjust to having less salt, you might not even miss it.

The challenge with avoiding sodium is that many foods at the supermarket are loaded with it. “It’s difficult to find packaged foods that don’t have a lot of sodium,” Hunnes says. Although she stresses the importance of reading food labels and understanding sodium levels, she recommends being particularly cautious of the following foods:

  1. Bread: Some sandwich breads have 300 to 400 mg of sodium per slice, she says. “If you’re making a sandwich, that could be more than a third of your daily allotment of sodium.”
  2. Canned soups: “Canned soups can have 1,000 mg or more of sodium in a can,” Hunnes says. Look for soups marked “low sodium,” and then check the label to be sure.
  3. Canned beans: Beans don’t naturally have sodium, but during cooking and canning, processors usually add salt. Again, look for low-sodium options. You can also rinse canned beans before using them. Or buy dry beans and cook them yourself.
  4. Frozen dinners: The wrong pizza or fried chicken dinner could deliver more than a full day’s worth of sodium in one meal.
  5. Condiments and salad dressings: “Prepared salad dressings can have 400 mg per serving,” says Hunnes. Keep an eye out for low-sodium options, or make your own dressing at home.
  6. Sodas (even diet ones): A 20-ounce bottle of Diet Dr Pepper has 100 mg of sodium. “That is a lot of sodium for no calories,” Hunnes says.
  7. Cheese: Many cheeses are loaded with sodium, but some types are better than others. “Mozzarellas tend to be lower in sodium,” Hunnes says. You might also find that Parmesan is allowable. It’s high in sodium, but if you’re using just a sprinkle to add flavor, the overall impact will be low. Hunnes also recommends nutritional yeast, which many vegans use as a substitute for cheese flavoring. It contains little sodium but adds the funky richness of cheese.
  8. Deli meat: Avoid cured meats such as ham or bacon. Non-cured options such as roasted turkey might be safe, but look at the label. “There are some brands out there that have no added sodium, whereas other brands can have 600 to 700 mg per serving,” Hunnes says.

In addition to sodium, you should keep an eye on potassium, Hunnes says: “ACE inhibitors can interfere with how your body processes potassium. It can actually build up in the blood a little bit.”

As a general rule, she recommends capping potassium at 2,000 mg per day. That means limiting food such as:

  • Avocados (728 mg per cup)
  • Yams (1,220 mg per cup)
  • Potatoes (638 mg per cup)
  • Tomatoes (427 mg per cup)
  • Bananas (537 mg per cup)
  • Nu-Salt (1,290 mg per ½ teaspoon) or other salt substitutes made with potassium

If limiting potassium seems difficult, have your doctor check your lab work. Most people don’t have as much of a problem with potassium as they do with sodium, says Dr. Abramov. So you might have more freedom to eat the foods you enjoy.

In either case, a deliberate approach to diet is important. It can have a huge impact on your heart health. And as for medication, we may be able to help: Download our mobile app to search for coupons for your prescriptions. You could save up to 80% at the pharmacy.

 

Additional sources
DASH overview:
National Institutes of Health
DASH is one of the best diets: U.S. News & World Report