Can lisinopril cause acid reflux

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Can Lisinopril Cause Acid Reflux?

Introduction to Lisinopril and Acid Reflux

Lisinopril is a commonly prescribed angiotensin-converting enzyme (ACE) inhibitor used to manage hypertension and heart failure. Acid reflux, or gastroesophageal reflux disease (GERD), occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

Impact of Antihypertensive Drugs on Acid Reflux

Comparative Analysis of Antihypertensive Drugs

A study aimed to investigate the effects of different antihypertensive drugs, including lisinopril, on acid reflux in patients with both GERD and hypertension. The study monitored esophageal and gastric pH levels in patients treated with valsartan, lisinopril, bisoprolol, and amlodipine. The results indicated that patients taking valsartan experienced a significant increase in acid reflux episodes compared to those on lisinopril or amlodipine. However, there were no significant differences in acid reflux indicators among patients treated with lisinopril, bisoprolol, and amlodipine .

Lisinopril and Esophageal Motility

The same study concluded that the increase in acid reflux observed in the valsartan group was not due to the acid-inducing effects of the drug but rather other factors affecting esophageal motility. This suggests that lisinopril does not significantly impact esophageal motility or increase the likelihood of acid reflux compared to other antihypertensive medications .

Lisinopril and Swallowing Reflex

Effects on Swallowing Dysfunction

Another study explored the effects of topical lisinopril on swallowing dysfunction in rats with cerebral hypoperfusion. The study found that lisinopril enhanced the swallowing reflex by increasing the number of swallows and reducing the latency period. This effect was attributed to the potentiation of substance P (SP) action, which is degraded by ACE and whose action is enhanced by ACE inhibitors like lisinopril .

Implications for GERD Patients

While this study focused on swallowing reflex rather than acid reflux, it provides insight into the broader effects of lisinopril on the esophageal region. The enhancement of the swallowing reflex could potentially benefit patients with dysphagia, a condition often associated with GERD, by improving esophageal motility and reducing the risk of aspiration .

Conclusion

Current research indicates that lisinopril does not significantly increase the risk of acid reflux compared to other antihypertensive medications. While it may enhance swallowing reflexes, which could be beneficial for patients with dysphagia, there is no direct evidence to suggest that lisinopril exacerbates acid reflux. Therefore, patients on lisinopril for hypertension or heart failure can be reassured that their medication is unlikely to worsen GERD symptoms.

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Most relevant research papers on this topic

Comparative analysis of the results of 3-hour esophageal-gastric-pH monitoring in patients with combined course of gastroesophageal reflux disease and arterial hypertension depending on the available antihypertensive pharmacotherapy

Valsartan may increase acid reflux episodes and decrease esophageal motility in patients with combined hypertension and gastroesophageal reflux disease, due to factors other than acid-induced effects.

2019·

0citations

·I. Paliy et al.

DOI

Topical laryngopharyngeal lisinopril enhances swallowing reflux in rats with cerebral hypoperfusion

Topical lisinopril can improve swallowing dysfunction in chronic cerebral hypoperfusion rats by increasing substance P secretion and reducing latency.

2019·

0citations

·Hirokazu Matsuzaki et al.

Proceedings for Annual Meeting of The Japanese Pharmacological Society·

DOI

No effects of high-dose omeprazole in patients with severe airway hyperresponsiveness and (a)symptomatic gastro-oesophageal reflux.

High-dose omeprazole does not improve pulmonary symptoms and function in patients with asthma and chronic obstructive pulmonary disease, despite reducing acid reflux.

RCT

1998·

110citations

·M. Boeree et al.

The European respiratory journal·

DOI

Lisinopril ameliorates paraquat-induced lung fibrosis.

Lisinopril effectively protects against paraquat-induced lung fibrosis, potentially due to inhibition of angiotensin II or proline moiety.

RCTAnimal Study

2006·

52citations

·Ali Mohammadi‐Karakani et al.

Clinica chimica acta; international journal of clinical chemistry·

DOI

Lifestyle intervention in gastroesophageal reflux disease

Weight loss and tobacco smoking cessation can reduce esophageal acid exposure and symptoms in GERD patients, while avoiding late evening meals and using bed elevation can help with nocturnal GERD.

Systematic Review

2015·

322citations

·E. Ness-Jensen et al.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association·

DOI

Lisinopril in the treatment of hypertensive patients with renal impairment.

Lisinopril effectively reduces blood pressure and is generally well-tolerated in hypertensive patients with impaired renal function.

1988·

16citations

·J. Donohoe et al.

The American journal of medicine·

DOI

Double blind cross-over placebo controlled study of omeprazole in the treatment of patients with reflux symptoms and physiological levels of acid reflux--the "sensitive oesophagus".

Omeprazole improves symptoms in 11 out of 18 patients with normal acid reflux levels, particularly in those with a positive symptom index, supporting the theory that these patients have a "sensitive" oesophagus.

RCT

1997·

231citations

·R. Watson et al.

Gut·

DOI

Effects of ACE Inhibitor (Lisinopril) with Folic Acid Supplementation in the Management of Hypertension Associated with Hyperuricemia

Folic acid supplementation enhances the effectiveness of ACE inhibitors (lisinopril) and significantly lowers serum uric acid levels in mild to moderate hypertension associated with hyperuricemia.

RCT

2022·

0citations

·Asif Aziz et al.

Journal of Pharmaceutical Research International·

DOI

Gastroesophageal reflux might cause esophagitis through a cytokine-mediated mechanism rather than caustic acid injury.

Gastroesophageal reflux may cause esophagitis through a cytokine-mediated mechanism rather than directly damaging the esophagus.

2009·

395citations

·R. Souza et al.

Gastroenterology·

DOI

Role of acid and duodenogastroesophageal reflux in gastroesophageal reflux disease.

Both acid and duodenogastroesophageal reflux (DGER) show a graded increase in severity across the GERD spectrum, occurring simultaneously in the majority of reflux episodes.

1996·

548citations

·M. Vaezi et al.

Gastroenterology·

DOI

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