Although it is a well-tolerated ACE inhibitor, PER shares the common side effects of the class but with a lower risk of incidence; it can cause dry cough (due, at least partially, to the accumulation of bradykinines), hypotension, hyperkalemia (because of a decrease in aldosterone), and a reversible decline in renal function (due to decreased renal perfusion secondary to bilateral renal artery stenosis, volume depletion, or severe congestive heart failure) [3]. This evidence concerns the gene ACE and congestive heart failure.