Angiotensin converting enzyme, receptor blockers and information, benefit
May 16 2016 by
Ray Sahelian, M.D.

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. If you are interested in reducing blood pressure naturally with nutritional supplements, see this article on hypertension.

Angiotensin converting enzyme benefit
Angiotensin coverting enzyme inhibitor drugs belong to the class of medicines called high blood pressure medicines. An ACE inhibitor drug is able to lower blood pressure. ACE 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. However chronic cough can occur in a large number of users. After discontinuation of an ACE inhibitor, cough can persist for several weeks afterwards but most people notice the cough to go away within a month.

Angiotensin converting enzyme Inhibitors and heart attack, MI
Lisinopril, captopril, ramipril, and trandolapril are 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 converting enzyme inhibitors and CHF
These drugs are used to treat congestive heart failure.


Angiotensin converting 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.

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 converting enzyme inhibitors and diabetes, high blood sugar
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 converting 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.
To observe the effects of quercetin on angiotensin induced interleukin-6 (IL-6) in vascular smooth muscle cells.  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. 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.

Angiotensin receptor blockers
The drugs are known as angiotensin-receptor blockers (ARBs) and include medicines such as telmisartan (Micardis), losartan (Cozaar), valsartan (Diovan) and candesartan (Atacand).

Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis;
British Medical Journal 2010.
To investigate whether angiotensin receptor blockers protect against Alzheimer's disease and dementia or reduce the progression of both diseases. DESIGN: Prospective cohort analysis.Time to incident Alzheimer's disease or dementia in three cohorts (angiotensin receptor blockers, lisinopril, and other cardiovascular drugs, the "cardiovascular comparator") over a four year period (fiscal years 2003-6) using Cox proportional hazard models with adjustments for age, diabetes, stroke, and cardiovascular disease. Disease progression was the time to admission to a nursing home or death among participants with pre-existing Alzheimer's disease or dementia. Angiotensin receptor blockers are associated with a significant reduction in the incidence and progression of Alzheimer's disease and dementia compared with angiotensin converting enzyme inhibitors or other cardiovascular drugs in a predominantly male population.

PLoS One. 2014. Angiotensin II Receptor Blocker Ameliorates Stress-Induced Adipose Tissue Inflammation and Insulin Resistance.