Alternatives to lisinopril for hypertension
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ACE Inhibitor Alternatives to Lisinopril for Hypertension
Lisinopril is a commonly prescribed angiotensin-converting enzyme (ACE) inhibitor for hypertension, but several alternatives exist, both among other pharmaceuticals and emerging natural compounds.
Pharmaceutical Alternatives: Enalapril and Hydrochlorothiazide
Enalapril, another ACE inhibitor, is a direct pharmaceutical alternative to lisinopril. Both drugs effectively lower blood pressure, but enalapril has shown additional benefits in improving arterial endothelial function, which lisinopril does not provide. This suggests that enalapril may offer cardiovascular advantages beyond blood pressure control, especially in newly diagnosed hypertensive patients .
Hydrochlorothiazide, a thiazide diuretic, is also used as an alternative to lisinopril. In obese hypertensive patients, both lisinopril and hydrochlorothiazide were equally effective in lowering blood pressure. However, lisinopril may be preferable for patients at higher risk of metabolic disorders, as hydrochlorothiazide was associated with increased plasma glucose and decreased potassium levels .
Natural and Food-Derived ACE Inhibitors
Research is increasingly exploring natural compounds as alternatives to synthetic ACE inhibitors like lisinopril. Peptides derived from food sources, such as arachin from peanuts, have demonstrated ACE inhibitory activity similar to lisinopril in laboratory studies. These peptides act as competitive inhibitors and may be useful for blood pressure management, though more research is needed to confirm their effectiveness in humans .
Plant-Based and In Silico-Identified Compounds
Several plant-derived compounds have shown promise as ACE inhibitors in computational studies. For example, luteolin derivatives from corn silk (Zea mays L.), particularly the compound TL59, have demonstrated strong binding affinity and stability with the ACE enzyme, potentially surpassing lisinopril in predicted efficacy and safety. However, these findings are based on in silico models and require further laboratory and clinical validation .
Similarly, compounds identified in medicinal plants from southwestern Nigeria, such as oxacycloheptadecan-2-one from Bacopa florinbunda, have shown high stability and inhibitory potential against ACE in computational studies. This compound was found to be more stable than lisinopril in molecular dynamics simulations, suggesting it could be a promising candidate for future antihypertensive therapies, pending experimental confirmation .
Conclusion
Alternatives to lisinopril for hypertension include other ACE inhibitors like enalapril, which may offer additional cardiovascular benefits, and thiazide diuretics like hydrochlorothiazide, which are equally effective but may have different metabolic side effects. Natural peptides and plant-derived compounds are emerging as potential alternatives, with promising results in early laboratory and computational studies. However, these natural options require further research to confirm their safety and effectiveness in clinical settings 12345.
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