Which of the following is an absolute contraindication to ACE inhibitors or ARBs?

• A. Asthma
• B. Hyperlipidemia
• C. Pregnancy
• D. Hypertension

Answer: (C)

The key idea is that pregnancy is an absolute contraindication for ACE inhibitors and ARBs because these drugs can cause serious harm to the developing fetus. They block the renin–angiotensin system, which is important for fetal kidney development. In the fetus this can lead to reduced kidney function, oligohydramnios (low amniotic fluid), and even fetal injury or death. For this reason, these medications should not be used at any stage of pregnancy.

In a patient who is not pregnant, these drugs are commonly used to treat hypertension, heart failure, and some kidney diseases, but the safety concern in pregnancy makes them off-limits there. The other options—asthma, high cholesterol, and hypertension—do not inherently prohibit ACE inhibitors or ARBs in nonpregnant individuals, so they’re not absolute contraindications.