scholarly journals Effect of an angiotensin-converting-enzyme inhibitor on the plasma concentration of cytokines and vasoactive molecules in patients with coronary heart disease and hypertension

2017 ◽  
Vol 89 (12) ◽  
pp. 97-102
Author(s):  
A A Khadartsev ◽  
A V Logatkina ◽  
I V Terekhov ◽  
S S Bondar ◽  
N V Bondar
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Plasma Level ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitor ◽  
Enzyme Inhibitor ◽  
Plasma Concentrations ◽  
High Plasma ◽  
Converting Enzyme ◽  
Inhibitor Level

Aim. To investigate the plasma concentrations of cytokines and vasoactive molecules in patients with coronary heart disease (CHD) in the presence of hypertension in relation to the angiotensin-converting-enzyme (ACE) inhibitor level reflecting the degree of renin-angiotensin-aldosterone system (RAAS) inhibition. Subjects and methods. 72 patients with NYHA functional class (FC) II-III angina pectoris and 40 healthy persons at the age of 47-65 years were examined in a controlled cohort study. Enzyme immunoassay was employed to determine the serum concentrations of interleukins (IL) (IL-2, IL-12, IL-17A, and IL-24), the vasoactive molecules of bradykinin, serotonin, ACE, angiotensin-II (AT-II), NO, and endothelin-1 (ET-1), and plasma renin activity. In addition, the plasma level of the tetrapeptide N-acetyl-Ser-Asp-Lys-Pro was used as a marker for ACE inhibition. Results. The patients with CHD occurring in the presence of hypertension compared with the apparently healthy individuals displayed decreased ET-1 and NO production along with elevated levels of serotonin, AT-II, as well as IL-17A and IL-12. The found changes were accompanied by reduced renin activity. Thus, the individuals with low ACE inhibitor levels showed more pronounced production of the proinflammatory cytokine IL-17A, as well as high plasma concentrations of ACE and NO. The high ACE inhibitor level that reflects patient adherence to appropriate antihypertensive therapy is associated with the reduced production of IL-2 and with the minimum serum levels of ACE, AT-II, and NO, being characterized by the high production of IL-12 and serotonin at the same time. Conclusion. In patients with CHD and hypertension, the high plasma enzyme inhibitor concentration that reflects the activity of appropriate antihypertensive therapy, by contributing to the strengthening of the mechanisms of relaxation of blood vessels, is associated with the risk for proinflammatory activation of whole blood cells and platelets. The mean ACE inhibitor levels that reflect moderate RAAS suppression and are characterized by a relatively low proinflammatory activation of mononuclear cells may be more preferable than the maximum ones, from the point of view of slowing the progression of the subclinical inflammatory process of the vascular wall and preventing possible CHD exacerbations. This determines the feasibility of estimating the plasma level of an ACE inhibitor to control the depth of inhibition of RAAS activity.

Microcirculatory Disturbances and Their Correction by Angiotensin-Converting Enzyme Inhibitor Lisinopril in Patients with Coronary Heart Disease Combined with Diabetes Mellitus Type 2

2015 ◽  
Vol 22 (3) ◽  
pp. 116-121
Author(s):  
Хасаев ◽  
A. Khasaev ◽  
Чиликина ◽  
N. Chilikina ◽  
Абусуев ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Diabetes Mellitus Type 2 ◽  
Enzyme Inhibitor ◽  
Converting Enzyme

A coronary heart disease and diabetes mellitus type 2 are the most complicated and urgent problem of medical science and public health. The standard therapeutic measures in some cases do not provide significant clinical improvement of patients with a stable course of the disease. This requires further study of the pathogenesis of the heart and vessels lesions in patients with combined pathology and the search for new medicines. In this work, the authors studied the state of microcirculation with the morphological assessment of the microvascular bed, considering the effectiveness of therapeutic effects of angiotensin-converting enzyme inhibitor lisinopril a daily dose of 5 mg in patients with ischemic heart disease (IHD), stable angina ΠΙ FC in combination with type 2 diabetes. Baseline, after 1 and 6 months of treatment, the authors conducted a conjunctival biomicroscopy of the eye vessels with a caliber measurement and mor-phometric analysis. The results of the study were the following: the combination of IHD and type 2 diabetes forms the gross disorders of microcirculation. This is reflected in the development of widespread perivascular edema, multiple hemorrhages, sudden depletion of the vascular bed with nonvascular lesions, intravascular aggregation of erythrocytes -"sludge-phenomenon". The prolonged complex use of lisinopril caused the positive dynamics of microcirculatory disorders, in particular, intravascular link with increasing flow velocity and decreasing the aggregation of erythrocytes. This is the basis for recommendations to the widespread use of this drug in this combined pathology.

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

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.

Key Drawbacks of Secondary Ischemic Heart Disease Prevention With Drug Therapy: the Role of Combination Fixed Dose Preparations in Solution of This Problem

Kardiologiia ◽  
2018 ◽  
Vol 58 (11) ◽  
pp. 17-23
Author(s):  
S. R. Gilyarevsky ◽  
M. V. Golshmid ◽  
I. M. Kuzmina
Keyword(s):  
Heart Disease ◽  
Drug Therapy ◽  
Angiotensin Converting Enzyme ◽  
Ischemic Heart Disease ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Converting Enzyme ◽  
Optimal Composition ◽  
Converting Enzyme Inhibitor ◽  
Combination Preparation

In this article we deal with the problem of low adherence of patients with ischemic heart disease (IHD) to drug therapy congruent to current recommendations including patients who underwent invasive interventions aimed at myocardial revascularization. Based on analysis of literature, we undertake an attempt to answer the question: which of components of this therapy patients with IHD are the least likely to continue taking? We also discuss approaches to the search for optimal composition of a combination preparation with fixed doses of an adreno-blocker and angiotensin converting enzyme inhibitor. Based on analysis of literature we undertook an attempt to answer a question: which of components of this therapy patients with IHD are least likely to continue taking. We also included in this article discussion of approaches to the search of optimal composition of a combination preparation containing fixed doses of a в-adrenoblocker and angiotensin converting enzyme inhibitor, as well as data on the role in the treatment of patients with IHD of bisoprolol and perindopril. Fixed doses of these agents have been included into a novel combination preparation.

scholarly journals Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin–angiotensin–aldosterone inhibitors

2020 ◽  
Vol 41 (19) ◽  
pp. 1810-1817 ◽  
Author(s):  
Iziah E Sama ◽  
Alice Ravera ◽  
Bernadet T Santema ◽  
Harry van Goor ◽  
Jozine M ter Maaten ◽  
...  
Keyword(s):  
Heart Failure ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Ace Inhibitor ◽  
Validation Cohort ◽  
Independent Predictor ◽  
Plasma Concentrations ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Raas Inhibitors

Abstract Aims The current pandemic coronavirus SARS-CoV-2 infects a wide age group but predominantly elderly individuals, especially men and those with cardiovascular disease. Recent reports suggest an association with use of renin–angiotensin–aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme 2 (ACE2) is a functional receptor for coronaviruses. Higher ACE2 concentrations might lead to increased vulnerability to SARS-CoV-2 in patients on RAAS inhibitors. Methods and results We measured ACE2 concentrations in 1485 men and 537 women with heart failure (index cohort). Results were validated in 1123 men and 575 women (validation cohort). The median age was 69 years for men and 75 years for women. The strongest predictor of elevated concentrations of ACE2 in both cohorts was male sex (estimate = 0.26, P < 0.001; and 0.19, P < 0.001, respectively). In the index cohort, use of ACE inhibitors, angiotensin receptor blockers (ARBs), or mineralocorticoid receptor antagonists (MRAs) was not an independent predictor of plasma ACE2. In the validation cohort, ACE inhibitor (estimate = –0.17, P = 0.002) and ARB use (estimate = –0.15, P = 0.03) were independent predictors of lower plasma ACE2, while use of an MRA (estimate = 0.11, P = 0.04) was an independent predictor of higher plasma ACE2 concentrations. Conclusion In two independent cohorts of patients with heart failure, plasma concentrations of ACE2 were higher in men than in women, but use of neither an ACE inhibitor nor an ARB was associated with higher plasma ACE2 concentrations. These data might explain the higher incidence and fatality rate of COVID-19 in men, but do not support previous reports suggesting that ACE inhibitors or ARBs increase the vulnerability for COVID-19 through increased plasma ACE2 concentrations.

Sign in / Sign up

Export Citation Format

Share Document