scholarly journals Angiotensin-Converting Enzyme Inhibitors Reduce Uterine Fibroid Incidence in Hypertensive Women

2020 ◽  
Author(s):  
Nicole M Fischer ◽  
Tim O Nieuwenhuis ◽  
Bhuchitra Singh ◽  
Gayane Yenokyan ◽  
James H Segars
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
The United States ◽  
Population Based ◽  
Research Database ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

Absctract Context In vitro and in vivo evidence has supported the role of angiotensin II blockade in reducing leiomyoma cell proliferation and growth. However, no population-based study to date has investigated this potential association. Objective This work aims to determine whether prior angiotensin-converting enzyme inhibitor (ACEi) use is associated with a reduced odds of leiomyoma development. Design A nested case-control study was conducted. Setting The population was assembled from the Truven Health MarketScan Research Database, which includes private health insurance claims from January 1, 2012 to December 31, 2017. Patients or Other Participants We included (n = 353 917) women age 18 to 65 with hypertension. Cases (n = 13 108) with a leiomyoma diagnosis were matched to controls (n = 340 808) with no such diagnosis at a 1:26 ratio by age and region of origin within the United States. Intervention Prior ACEi use was determined from outpatient drug claims. Main Outcome Measure Leiomyoma development was indicated by a first-time diagnosis code. Results Women on an ACEi experienced a 31.8% reduced odds of developing clinically recognized leiomyoma compared to nonusers (odds ratio [OR] 0.68; 95% CI, 0.65-0.72). This association was significant for each age group: 30 to 39 years (OR 0.86; 95% CI, 0.74-0.99), 40 to 49 years (OR 0.71; 95% CI, 0.66-0.76), 50 to 59 years (OR 0.63; 95% CI, 0.58-0.69), and 60 to 65 years (OR 0.58; 95% CI, 0.50-0.69). Of the ACEis, lisinopril (OR 0.67; 95% CI, 0.64-0.71), quinapril (OR 0.62; 95% CI, 0.41-0.92), and ramipril (OR 0.35; 95% CI, 0.23-0.50) demonstrated a significant association with reduced leiomyoma incidence. Conclusions ACEi use was associated with a reduced odds of developing clinically recognized leiomyoma in adult hypertensive women.

Abstract P423: Chronic Doxycycline Administration Inhibits Angiotensin Converting Enzyme Activity and Exerts Antioxidants Effects in Renovascular Hypertensive Rats

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Elen Rizzi Sanchez ◽  
Giselle F Bonacio ◽  
Danielle A Guimaraes ◽  
Gustavo Oliveira Paula ◽  
Jefferson Henrich Amaral ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Cardiovascular Effects ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Hypertensive Rats ◽  
Angiotensin I ◽  
Converting Enzyme Inhibitors ◽  
Ace Activity

Doxycycline (Dox), an established matrix metalloproteinase (MMP) inhibitor, and angiotensin-converting enzyme inhibitors (ACEi) present beneficial cardiovascular effects which could be consequence of their antioxidants properties. Furthermore, some evidences have shown other biochemical similarities between Dox and ACEi suggesting that Dox could also inhibit ACE and ACEi directly interact with MMPs and inhibit these proteases. Supporting this idea, Dox is able to chelate divalent metals, such as calcium and zinc, which are essential for the ACE activity. In this regard, we hypothesized that Dox inhibits ACE activity in hypertensive rats which leads to a reduction in ROS production and decrease hypertension. Sham-operated or 2K1C hypertensive rats were treated with Dox (30 mg/Kg/day) or water for 4 weeks. Systolic blood pressure (SBP) was monitored weekly. Dox treatment reduced SBP in 2K1C rats from 200±12 mmHg to 158±8 mmHg (P<0.05). In addition, Dox treatment attenuated reactive oxygen species (ROS) levels in hypertensive animals measured by lucigenin chemiluminescense (in RLU/mg of aorta: from 711±1.0 to 377±93; P<0.05). ACE activity in aorta was increased in untreated 2K1C rats (22±0.8 nmols/min/g) when compared with the Sham group (12±1.0 nmols/min/g; P<0.05) and Dox treatment was able to reduce ACE activity in 2K1C rats (15±2.0 nmols/min/g; P<0.05). To evaluate whether Dox inhibits ACE activity in vitro , aortic tissues from 2K1C rats were incubated with Dox or Captopril (a known ACEi ). Dox in vitro did not affect ACE activity while captopril inhibited 80% of its activity. To verify whether Dox could inhibit ACE activity in vivo , an acute assay was performed with different doses of angiotensin I (in μg/Kg: 0.03, 0.3 and 3), after the single administration of Dox or saline (i.p.). Angiotensin I infusion increased mean arterial pressure dose-dependently and Dox pretreatment did not attenuated these increases significantly (P>0.05) as Captopril.Taken together, these results show that chronic treatment with Dox inhibits ACE activity in aorta of 2K1C rats, which contribute to ROS reduction and SBP attenuation. However, the mechanism by which Dox inhibits ACE activity needs further investigation.

Domestic practice of antihypertensive treatment of diabetic hypertensive patients

2014 ◽  
Vol 155 (43) ◽  
pp. 1695-1700
Author(s):  
Veronika Szentes ◽  
Gabriella Kovács ◽  
Csaba András Dézsi
Keyword(s):  
Blood Pressure ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Enzyme Inhibitor ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Patients With Diabetes

Diabetes mellitus as comorbidity is present in 20–25% of patients suffering from high blood pressure. Because simultaneous presence of these two diseases results in a significant increase of cardiovascular risk, various guidelines focus greatly on the anti-hyperintensive treatment of patients with diabetes. Combined drug therapy is usually required to achieve the blood pressure target value of <140/85 mmHg defined for patients with diabetes, which must be based on angiotensin converting enzyme-inhibitors or angiotensin receptor blockers. These can be/must be combined with low dose, primarily thiazid-like diuretics, calcium channel blockers with neutral metabolic effect, and further options include the addition of beta blockers, imidazolin-l-receptor antagonists, or alpha-1-adrenoreceptor blockers. Evidence-based guidelines are obviously present in local practice. Although most of the patients receive angiotensin converting enzyme-inhibitor+indapamid or angiotensin converting enzyme-inhibitor+calcium channel blocker combined therapy with favorable metabolic effects, yet the use of angiotensin converting enzyme-inhibitors containing hidrochlorotiazide having diabetogenic potencial, and angiotensin receptor blocker fixed combinations is still widespread. Similarly, interesting therapeutic practice can be observed with the use of less differentiated beta blockers, where the 3rd generation carvediolol and nebivolol are still in minority. Orv. Hetil., 2014, 155(43), 1695–1700.

Angioedema induced by angiotensin-converting enzyme inhibitors: an analysis of hospitalizations during the COVID-19 pandemic

2021 ◽  
Author(s):  
Tatsiana М. Sabalenka ◽  
Volha V. Zakharava ◽  
Natallia R. Prakoshyna
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Converting Enzyme Inhibitor ◽  
Receptor Blockers

Backgraund: The pathogenesis of angioedema induced by angiotensin-converting enzyme inhibitors is based on the accumulation of bradykinin as a result of angiotensin-converting enzyme blockade. The SARS-CoV-2 virus by binding to the angiotensin-converting enzyme 2 receptor, may inhibit its production, which in turn leads to an increase in bradykinin levels. Thus, infection with SARS-CoV-2 may be a likely trigger for the development of angioedema. Aims: to analyze the cases of hospitalizations of patients with angioedema associated with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers during the COVID-19 pandemic. Materials and methods: a retrospective analysis of the medical records of inpatient patients admitted to the Vitebsk Regional Clinical Hospital in May-December 2020 with isolated (without urticaria) angioedema while receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was performed. All patients received smears from the naso- and oropharynx for COVID-19 by polymerase chain reaction. Results: there were admitted 15 patients (9 men and 6 women) aged 44-72 years for emergency indications, which was 53.6% among all patients with isolated angioedema. In two cases, a concomitant diagnosis of mild COVID-19 infection was established with the predominance symptoms of angioedema in the clinical picture with localization in the face, tongue, sublingual area, soft palate. All patients had a favorable outcome of the disease. Conclusions: patients with аngiotensin-converting enzyme inhibitor-induced angioedema may need to be hospitalized to monitor upper respiratory tract patency. There were cases of a combination of аngiotensin-converting enzyme inhibitor-induced angioedema and mild COVID-19 infection. Issues requiring additional research: the effect of SARS-CoV-2 infection on the levels of bradykinin and its metabolites; the trigger role of COVID-19 infection in the development of angioedema in patients receiving angiotensin-converting enzyme inhibitors/angiotensin receptor blockers; recommendations for the management of patients with аngiotensin-converting enzyme inhibitor-induced angioedema and a positive result for COVID-19.

Angiotensin-converting enzyme determination in plasma during therapy with converting enzyme inhibitor: two methods compared

1991 ◽  
Vol 37 (8) ◽  
pp. 1390-1393 ◽  
Author(s):  
T P Gorski ◽  
D J Campbell
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Spectrophotometric Method ◽  
Enzyme Inhibitor ◽  
Ang Ii ◽  
Converting Enzyme ◽  
Fluorometric Method ◽  
Converting Enzyme Inhibitor ◽  
Ace Activity

Abstract For normal and above-normal concentrations of angiotensin-converting enzyme (ACE; EC 3.4.15.1) activity in plasma, results of a manual fluorometric method [with hippuryl-histidyl-leucine (HHL), 5 mmol/L, as substrate] correlated well with those of an automated spectrophotometric method [with 3-(2-furylacryloyl)-L-phenylalanyl-glycyl-glycine (FAPGG), 2 mmol/L, as substrate]. However, for patients receiving converting enzyme inhibitor (CEI) therapy, the spectrophotometric method showed much greater suppression of plasma ACE activity than did the fluorometric method. To determine which of the two methods provided a more reliable indication of ACE inhibition in vivo, we measured plasma ACE, angiotensin I (ANG I), and angiotensin II (ANG II) in patients receiving the CEI perindopril. During perindopril therapy, changes in the ratio of ANG II:ANG I, an index of ACE activity in vivo, showed a close agreement with changes in plasma ACE activity measured with FAPGG as substrate, but not with HHL as substrate. We conclude that measurement of ACE activity in vitro with FAPGG as substrate provides a reliable measure of changes in conversion of ANG I to ANG II in vivo during CEI therapy.

Late-Onset Life-Threatening Angioedema and Upper Airway Obstruction Caused by Angiotensin-Converting Enzyme Inhibitor: Report of a Case

1997 ◽  
Vol 76 (6) ◽  
pp. 404-407 ◽  
Author(s):  
Ping-Kun Weng ◽  
Hsing-Won Wang ◽  
John K. Lin ◽  
Wen-Yang Su
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Airway Obstruction ◽  
Enzyme Inhibitor ◽  
Late Onset ◽  
Upper Airway ◽  
Temporal Correlation ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Upper Airway Obstruction ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors

Angioedema is a rare but potentially lethal adverse effect when associated with upper airway obstruction. Sporadic cases of angioedema secondary to angiotensin converting enzyme inhibitors (ACEI) have been reported in the literature. The overall incidence is around 0.1% to 0.2%, and the time of onset is usually during the first week of ACEI therapy. Late-onset angioedema secondary to treatment with ACEIs is much more frequent than appreciated, and is largely unrecognized because of the absence of temporal correlation between ACEI therapy and the development of angioedema. Since angioedema may progress to upper airway obstruction, otolaryngologists must be aware of this association. Most importantly, late-onset angioedema should alert the clinician to discontinue the A CEI immediately to prevent further morbidity. This report presents an example of late-onset angioedema which was precipitated by taking a double dose of Captopril incidentally. The case is discussed, and the literature, pathophysiology and treatment of angioedema are reviewed.

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