Does lisinopril affect heart rate
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The Impact of Lisinopril on Heart Rate: A Comprehensive Review
Introduction to Lisinopril and Heart Rate
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used to manage hypertension and heart failure. Understanding its effects on heart rate is crucial for optimizing treatment strategies for patients with cardiovascular conditions.
Lisinopril and Heart Rate Variability
Heart Rate Variability in Chronic Heart Failure
Research indicates that lisinopril can influence heart rate variability (HRV) in patients with chronic heart failure (CHF). A study comparing lisinopril and valsartan found no significant differences between the two drugs in their effects on autonomic control of heart rate, as measured by HRV and baroreflex sensitivity. Both medications significantly reduced plasma norepinephrine levels, although valsartan had a more pronounced effect.
Heart Rate Variability in Hypertensive Rats
In animal models, lisinopril has been shown to improve HRV. A study on spontaneously hypertensive rats demonstrated that 10 weeks of lisinopril treatment significantly increased HRV during both active and inactive periods, suggesting enhanced autonomic regulation of heart rate.
Lisinopril and Exercise-Induced Heart Rate Response
Heart Rate Response in Heart Failure and Atrial Fibrillation
In patients with congestive heart failure and chronic atrial fibrillation, lisinopril did not significantly affect heart rate during exercise or ambulatory monitoring. However, it did improve peak oxygen consumption and tended to lower plasma norepinephrine levels during exercise, indicating a potential attenuation of adrenergic drive.
Heart Rate Response Post-Myocardial Infarction
A study investigating the effect of lisinopril on heart rate response during exercise in the early phase of acute myocardial infarction found that lisinopril improved sympathetic heart rate response. This was evidenced by a higher heart rate response in the lisinopril group compared to controls during the first month post-infarction.
Lisinopril and Resting Heart Rate
Acute and Chronic Effects on Normotensive Individuals
In normotensive individuals, both acute and chronic administration of lisinopril reduced blood pressure without significantly altering resting heart rate. This suggests that lisinopril does not induce reflex tachycardia, which is often a concern with antihypertensive therapy.
Hemodynamic Effects in Heart Failure
In patients with heart failure, acute administration of lisinopril resulted in significant reductions in mean arterial pressure and systemic vascular resistance without significant changes in heart rate. This indicates that lisinopril can effectively lower blood pressure while maintaining stable heart rate.
Conclusion
Overall, lisinopril appears to have a neutral to beneficial effect on heart rate. It improves heart rate variability in both human and animal studies, enhances sympathetic heart rate response post-myocardial infarction, and does not significantly alter resting heart rate in normotensive individuals or patients with heart failure. These findings support the use of lisinopril as a safe and effective option for managing cardiovascular conditions without adversely affecting heart rate.
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