Angiotensin converting enzyme by Ray Sahelian, M.D. Angiotensin receptor Angiotensin II

Angiotensin is an peptide that circulates in the blood and leads to constriction of blood vessels, increased blood pressure, and release of aldosterone from the adrenal cortex. Angiotensin is derived from the precursor molecule angiotensinogen, a serum globulin produced in the liver. Angiotensin plays an important role in the renin-angiotensin system.

 

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Angiotensin coverting enzyme
Angiotensin coverting enzyme inhibitor drugs belong to the class of medicines called high blood pressure medicines. By inhibiting angiotensin coverting enzyme, an ACE inhibitor drug is able to lower blood pressure. Angiotensin coverting enzyme inhibitors are commonly prescribed for high blood pressure and heart failure. They also prevent heart damage following a heart attack and reduce the risk of kidney problems in people with diabetes.

Angiotensin coverting enzyme Inhibitors and Heart Attack
Lisinopril, captopril, ramipril, and trandolapril are angiotensin coverting enzyme inhibitor drugs used in some patients after a heart attack. After a heart attack, some of the heart muscle is damaged and weakened. The heart muscle may continue to weaken as time goes by. This makes it more difficult for the heart to pump blood.

Angiotensin coverting enzyme inhibitors and CHF
Angiotensin coverting enzyme inhibitor drugs are used to treat congestive heart failure.

 

Angiotensin coverting enzyme inhibitors after Heart Surgery

Treatment with angiotensin coverting enzyme inhibitors interferes with red blood cell formation and increases the risk of prolonged episodes of anemia after heart surgery. A study of 42 men with anemia after cardiac surgery was conducted at Istituto Maria Nascente Fondazione Don Carlo Gnocchi in Milan by Dr. Vittorino Ripamonti and colleagues. Approximately nine days after surgery, patients were randomized to the angiotensin coverting enzyme drug enalapril maleate or not. All patients received ferrous sulfate 325 mg plus standard post-cardiac surgical therapy, including beta-blockers and antiplatelet drugs if coronary artery disease was the setting, or diuretics and anticoagulants if it was valvular disease. At 16 days, patients receiving enalapril had peak hemoglobin levels 1 g/dL lower and red blood cell counts 444 RBCs/mL lower than patients not receiving the angiotensin coverting enzyme inhibitor. By 60 days after randomization, hemoglobin and RBC counts were moving toward normal in both groups, but remained lower in those on enalapril. "In the postoperative period, when a prompt erythropoietic response is crucial, the positive actions of (angiotensin coverting enzyme inhibitors) may be counterbalanced by persistent anemia, thus leading to a slower functional recovery," Dr. Ripamonti and colleagues conclude. Chest 2006;130:79-84.

Angiotensin coverting enzyme Inhibitors and Kidney Disease
Captopril is used to treat kidney problems in some diabetic patients who use insulin to control their diabetes. Over time, these kidney problems may get worse. Captopril may help slow down the further worsening of kidney problems.

Angiotensin coverting enzyme
inhibitors and diabetes
The results with ace inhibitors and diabetes onset delay has provided mixed results. In one study, treatment with ACE inhibitors appeared to delay mortality in patients with diabetes who also have microalbuminuria (and pre-existing heart disease) or frank albuminuria. However, a 3 year study with the ace inhibitor ramipril did not show any benefit. For the time being, diet and exercise are better options for the delay of diabetic symptoms that the use of an ace inhibitor.

 

Angiotensin coverting enzyme Inhibitors and Aortic Aneurysm

Treatment with an angiotensin coverting enzyme inhibitor is associated with a decreased risk of rupture in patients with abdominal aortic aneurysm.

Quercetin and angiotensin
Effects of quercetin on angiotensin II induced interleukin-6 in vascular smooth muscle cells
Zhong Yao Cai. 2006 Jul;29(7):683-6. Department of Pharmacology, Xi'an Jiao University of Medicine, China.
To observe the effects of quercetin on angiotensin induced interleukin-6 (IL-6) in vascular smooth muscle cells (VSMCs).  VSMCs were isolated from the thoracic aorta of Sprague-Dawley rats and were stimulated with different doses of angiotensin II. The production of IL-6 in supernatant of quercetin treated cultures was detected by ELISA. In parallel, interleukin-6 mRNA level was measured by RT-PCR. Angiotensin II induced a marked increase of interleukin-6 in a dose- and time-dependent manner in the culture of VSMCs. Quercetin inhibited the production of Ang II -induced interleukin-6 in the culture in a dose-dependent manner. Similarly, the result with RT-PCR indicated that the expression of interleukin-6 mRNA induced by angiotensin II for 24h was down-regulated by quercetin. CONCLUSION: It demonstrates that quercetin possesses a inhibition of angiotensin II-induced production of IL-6 in VSMCs. Moreover, quercetin also down regulates the expression of interleukin-6 mRNA, suggesting the action of quercetin on interleukin-6 release induced by angiotensin II in VSMCs may underlie its anti-inflammatory properties.