Delayed diagnosis of angiotensin-converting enzyme (ACE) inhibitor induced angioedema and urticaria

Inhibition of angiotensin-converting enzyme (ACE) is a strategy used worldwide for managing hypertension. In addition to converting angiotensin I to angiotensin II, ACE also converts neurotoxic β-amyloid protein 42 (Aβ42) to Aβ40. Because of its neurotoxicity, Aβ42 is believed to play a causative role in the development of Alzheimer's disease (AD), whereas Aβ40 has neuroprotective effects against Aβ42 aggregation and also against metal-induced oxidative damage. Whether ACE inhibition enhances Aβ42 aggregation or impairs human cognitive ability are very important issues for preventing AD onset and for optimal hypertension management. In an 8-year longitudinal study, we found here that the mean intelligence quotient of male, but not female, hypertensive patients taking ACE inhibitors declined more rapidly than that of others taking no ACE inhibitors. Moreover, the sera of all AD patients exhibited a decrease in Aβ42-to-Aβ40–converting activity compared with sera from age-matched healthy individuals. Using human amyloid precursor protein transgenic mice, we found that a clinical dose of an ACE inhibitor was sufficient to increase brain amyloid deposition. We also generated human amyloid precursor protein/ACE+/− mice and found that a decrease in ACE levels promoted Aβ42 deposition and increased the number of apoptotic neurons. These results suggest that inhibition of ACE activity is a risk factor for impaired human cognition and for triggering AD onset.

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Characterization of Angiotensin Converting Enzyme (ACE) in the Testis and Assessment of thein VivoEffects of the ACE Inhibitor Perindopril

Endocrinology ◽

10.1210/endo-123-1-50 ◽

1988 ◽

Vol 123 (1) ◽

pp. 50-55 ◽

Cited By ~ 18

Author(s):

BRUCE JACKSON ◽

ROSE B. CUBELA ◽

KEIJI SAKAGUCHI ◽

COLIN I. JOHNSTON

Keyword(s):

Angiotensin Converting Enzyme ◽

Ace Inhibitor ◽

Converting Enzyme

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A systematic review and meta-analysis of angiotensin-converting enzyme inhibitor use and psoriasis incidence

Scientific Reports ◽

10.1038/s41598-021-89490-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Gonjin Song ◽

Ji Yea Kim ◽

Ha Young Yoon ◽

Jeong Yee ◽

Hye Sun Gwak

Keyword(s):

Systematic Review ◽

Literature Review ◽

Angiotensin Converting Enzyme ◽

Subgroup Analysis ◽

Ace Inhibitor ◽

Web Of Science ◽

Enzyme Inhibitor ◽

Meta Analysis ◽

Temperate Climate ◽

Converting Enzyme

AbstractAlthough a considerable volume of data supporting induction or aggravation of psoriasis because of angiotensin-converting enzyme (ACE) inhibitor use exists, it remains insufficient for definitive conclusions. Therefore, we aimed to evaluate the association between ACE inhibitor use and psoriasis incidence through a systematic literature review and meta-analysis. We searched for qualifying studies across PubMed, Web of Science, and Embase. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between ACE inhibitor use and psoriasis incidence. Eight studies with a total of 54,509 patients with a psoriasis diagnosis were included in this meta-analysis. The pooled OR for psoriasis incidence among ACE inhibitor users was 1.52 (95% CI, 1.16–2.00) compared to that among non-users. From subgroup analysis by continent, the OR for ACE inhibitor users versus non-users was 2.37 (95% CI 1.28–4.37) in Asia. Per the subgroup analysis by climate, the OR for ACE inhibitor users vs non-users in dry climate was 3.45 (95% CI: 2.05–5.79) vs 1.32 (95% CI 1.01–1.73) in temperate climate. Our results reveal a significant association between ACE inhibitor use and psoriasis incidence.

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Multi-spectroscopic approaches and molecular simulation research of the intermolecular interaction between the angiotensin-converting enzyme inhibitor (ACE inhibitor) benazepril and bovine serum albumin (BSA)

Spectrochimica Acta Part A Molecular and Biomolecular Spectroscopy ◽

10.1016/j.saa.2018.12.040 ◽

2019 ◽

Vol 212 ◽

pp. 15-24 ◽

Cited By ~ 48

Author(s):

Bao-Li Wang ◽

Dong-Qi Pan ◽

Kai-Li Zhou ◽

Yan-Yue Lou ◽

Jie-Hua Shi

Keyword(s):

Bovine Serum Albumin ◽

Angiotensin Converting Enzyme ◽

Serum Albumin ◽

Intermolecular Interaction ◽

Angiotensin Converting Enzyme Inhibitor ◽

Bovine Serum ◽

Ace Inhibitor ◽

Enzyme Inhibitor ◽

Converting Enzyme ◽

Simulation Research

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Angiotensin-Converting Enzyme Gene Polymorphism and Erythropoietin Requirement

Peritoneal Dialysis International ◽

10.1177/089686080302300203 ◽

2003 ◽

Vol 23 (2) ◽

pp. 111-115 ◽

Cited By ~ 12

Author(s):

Mira Varagunam ◽

Daniel J. McCloskey ◽

Paul J. Sinnott ◽

Martin J. Raftery ◽

Muhammed M. Yaqoob

Keyword(s):

Renal Failure ◽

Parathyroid Hormone ◽

Angiotensin Converting Enzyme ◽

Ace Inhibitor ◽

Inhibitor Therapy ◽

Converting Enzyme ◽

C Reactive Protein ◽

Dose Requirement ◽

Reactive Protein ◽

Significant Difference

Objectives To study the effect of angiotensin-converting enzyme (ACE) polymorphisms II, ID, and DD on erythropoietin (EPO) requirement in patients on continuous ambulatory peritoneal dialysis (CAPD) therapy. Design Retrospective observational study. Setting CAPD Unit, Royal London/St. Bartholomews Hospital, London, UK. Patients 46 patients on the transplant waiting list (age 20 – 70 years), on CAPD therapy for an average of 28 months, seen consecutively over a period of 3 months in the outpatients department. Main Outcome Measures Primary end point: EPO dose requirement in different ACE genotypes. Secondary end points: C-reactive protein, ferritin, parathyroid hormone, Kt/V, duration of dialysis, folate, cause of renal failure, and whether or not patients were on ACE inhibitor therapy. Results There was a statistically significant difference ( p < 0.05) in EPO requirement in the II/ID group compared to the DD group. The mean ± standard error of EPO for the II/ID group was 144 ± 15 U/kg/week, and for the DD group, 87 ± 9 U/kg/ week. The difference in EPO requirement could not be explained by age, C-reactive protein, ferritin, parathyroid hormone, Kt/V, duration of dialysis, folate, cause of renal failure, or whether or not patients were on ACE inhibitor therapy. Conclusion In CAPD patients, ACE genotype has predictive value when determining the EPO dosage, as the II/ID genotype may be associated with a suboptimal response.

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The effects of the combination of angiotensin-converting enzyme inhibitor and diuretic on the lower limb venous circulation in men with hypertension and chronic venous disorders

Russian Journal of Cardiology ◽

10.15829/1560-4071-2020-3-3545 ◽

2020 ◽

Vol 25 (3) ◽

pp. 3545

Author(s):

S. V. Letyagina ◽

V. M. Baev ◽

S. A. Shmeleva ◽

T. Yu. Agafonova

Keyword(s):

Angiotensin Converting Enzyme ◽

Flow Velocity ◽

Antihypertensive Therapy ◽

Lower Limb ◽

Ace Inhibitor ◽

Venous Pressure ◽

Uncontrolled Hypertension ◽

Converting Enzyme ◽

Venous Circulation ◽

Venous Disorders

Aim. To study the effects of angiotensin converting enzyme (ACE) inhibitor and diuretic combination on the lower limb venous circulation in men with hypertension (HTN) and chronic venous disorders (CVD).Material and methods. The study included 37 men with uncontrolled hypertension at the age of 46 (40-49) years, which were divided into two groups: 20 patients with objective signs of CVD (CEAP criteria) and 17 patients without CVD. During hospitalization, all participants received antihypertensive therapy with a combination of ACE inhibitor and diuretic. Vein Doppler ultrasound at rest was performed on the day of hospitalization and after 14 days. The diameter and the area of vein lumen, flow velocity and peripheral venous pressure (PVP) were recorded. Mann-Whitney and Wilcoxon tests were used for statistical analysis.Results. Initially, patients with CVD had higher values of PBP (by 26%), diameter and area of the vein lumen (53%) and flow velocity (by 14%) than in patients without CVD. As a result of therapy, in the group of patients with HTN and without CVD, systolic (SBP) and diastolic blood pressure (DBP) decreased to the target levels, PVP decreased by 13%, vein diameter increased by 27%, blood flow velocity decreased by 15%. Therapy in patients with CVD led to the normalization of SBP, DBP, and a decrease in PVP and flow velocity by 31% and 33%, respectively. No significant changes in the diameter and cross-sectional area of lower limb veins were noted.Conclusion. The obtained data showed that 14-day antihypertensive therapy with ACE inhibitor and diuretic in patients with HTN and CVD, unlike patients with HTN and without CVD, did not led to vein dilation, but was associated with flow velocity and PVP decrease. By therapy’s end, most of venous hemodynamic parameters, including PVP, were identical in the studied groups.

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Comparative Effects of Preoperative Angiotensin-converting Enzyme In-hibitor, Statin and Beta-blocker Treatment on Human Internal Mammary Artery Reactivity in Patients with Coronary Artery Disease: A Pilot Study

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192401307010069 ◽

2013 ◽

Vol 7 (1) ◽

pp. 69-75 ◽

Cited By ~ 3

Author(s):

Selvinaz Dalaklioglu ◽

Ilhan Golbasi ◽

Caglar Ogutman

Keyword(s):

Angiotensin Converting Enzyme ◽

Beta Blocker ◽

Bypass Surgery ◽

Internal Mammary Artery ◽

Ace Inhibitor ◽

Control Group ◽

Maximal Effect ◽

Converting Enzyme ◽

Significant Difference ◽

Internal Mammary

Purpose: We investigated the effect of angiotensin-converting enzyme (ACE)- inhibitor, statin, and beta-blocker usage before coronary bypass surgery (CABG) on vascular reactivity of the internal mammary artery (IMA). Methods: Patients, who underwent elective CABG were evaluated. Samples of IMA obtained from 22 patients were divided into 4 groups in respect of drugs used by patients before bypass surgery (control group, ACE inhibitor + statin group, ACE inhibitor + statin + beta-blocker group, and ACE inhibitor + beta-blocker group). The discarded, distal end section of IMA was carefully removed, and the vasoreactivity of IMA rings was evaluated in vitro using an organ chamber. Smooth muscle contractile function was tested on artery segments exposed to 10-80 mM KCl and norepinephrine. The endothelial function of IMA rings was assessed with acetylcholine (ACh) and bradykinin, while endothelium-independent vasorelaxation was evaluated by sodium nitroprusside (SNP). Results: Both ACh and bradykinin caused concentration-dependent relaxation in endothelium-intact IMA rings. However, the maximal effect produced by endothelium-dependent agents in all treatment groups was more prominent when compared with the control group. There was no significant difference in the endothelium-dependent relaxation response of IMA between ACE inhibitor + statin, ACE inhibitor + beta-blocker and ACE inhibitor + statin + beta-blocker groups. The vasodilatory potency of SNP was similar in all groups. Similarly, contractile response to KCl or norepinephrine was not significantly different between groups. Conclusion: Use of ACE inhibitors and statins before bypass surgery may influence IMA vasoreactivity by improving endothelial control of vascular tone.

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▾Lisinopril - another ACE inhibitor

Drug and Therapeutics Bulletin ◽

10.1136/dtb.27.8.31 ◽

1989 ◽

Vol 27 (8) ◽

pp. 31-32

Keyword(s):

Heart Failure ◽

Angiotensin Converting Enzyme ◽

Antihypertensive Therapy ◽

Ace Inhibitor ◽

Converting Enzyme ◽

Once Daily ◽

The Third

Lisinopril (Carace - MSD, Zestril - ICI) has joined captopril and enalapril1 as the third inhibitor of angiotensin-converting enzyme (ACE), for use in hypertension and heart failure. Advantages claimed for lisinopril are that it is not a pro-drug, its once daily dosage and its ability “to retain that zest for life” during antihypertensive therapy.

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