Lisinopril cholesterol
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Effects of Lisinopril on Cholesterol and Lipid Profiles
Introduction to Lisinopril and Cholesterol
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is primarily used to treat hypertension and heart failure. Recent studies have explored its impact on cholesterol and lipid profiles, revealing diverse effects that can influence treatment decisions for patients with concurrent lipid abnormalities.
Lisinopril's Impact on Lipid Profiles in Chronic Nephropathies
In patients with chronic nephropathies, increasing doses of lisinopril have been shown to significantly reduce serum total cholesterol, LDL cholesterol, and triglycerides. This reduction is dose-dependent and persists even after treatment withdrawal. The study highlighted that the reduction in cholesterol levels was more pronounced in hypoalbuminemic patients compared to normoalbuminemic ones, indicating a potential benefit in patients with severe hypoalbuminemia1.
Neutral Effects in Hypertensive Patients
Contrary to the findings in nephropathic patients, a study involving hypertensive patients treated with lisinopril (10-40 mg) showed no significant changes in lipid levels, including total cholesterol, HDL cholesterol, and triglycerides. This suggests that lisinopril may have a neutral effect on lipid profiles in this population2.
Effects on Insulin Sensitivity and Lipid Metabolism
Lisinopril has also been studied for its effects on insulin sensitivity and lipid metabolism. In young adults with mild hypertension, lisinopril treatment resulted in a significant reduction in total cholesterol and LDL cholesterol. However, the study noted only a marginal increase in insulin sensitivity, indicating that while lisinopril can improve lipid profiles, its impact on insulin sensitivity may be limited3.
Improvement in Arterial Function in Hyperlipidemia
Lisinopril has been found to improve arterial function in patients with hyperlipidemia. A six-month treatment regimen led to significant improvements in vasodilatory responses, suggesting that lisinopril may have beneficial effects on endothelial function in hypercholesterolemic patients4.
Comparative Studies with Other Antihypertensive Agents
Comparative studies have shown that lisinopril, unlike some other antihypertensive agents, does not adversely affect lipid profiles. For instance, while hydralazine was found to lower total and LDL cholesterol, lisinopril did not significantly alter these lipid parameters, indicating its neutral impact on lipid metabolism5.
Animal Studies on Lipid Profiles
Animal studies have also supported the beneficial effects of lisinopril on lipid profiles. In albino rabbits, lisinopril treatment resulted in a decrease in serum cholesterol and LDL levels, with no significant changes in triglycerides and VLDL levels. This suggests a favorable impact on lipid profiles, which may translate to similar effects in humans6.
Anti-Inflammatory Benefits in HIV Patients
In patients with HIV, lisinopril has shown potential anti-inflammatory benefits. A study indicated significant declines in diastolic blood pressure, hsCRP, and TNF-α levels, suggesting that lisinopril may offer additional benefits beyond lipid profile improvement in this population7.
Conclusion
Lisinopril exhibits diverse effects on cholesterol and lipid profiles, varying with patient populations and underlying conditions. While it significantly reduces lipid levels in chronic nephropathies and shows potential benefits in hyperlipidemia and HIV patients, its impact appears neutral in hypertensive patients without additional comorbidities. These findings highlight the importance of considering individual patient profiles when prescribing lisinopril for managing cholesterol and lipid abnormalities.
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Most relevant research papers on this topic
Diverse Effects of Increasing Lisinopril Doses on Lipid Abnormalities in Chronic Nephropathies
Increasing lisinopril doses safely reduces proteinuria and dyslipidemia in chronic kidney disease patients without affecting HDL or renal hemodynamics.
Observational Study
Highly Cited[Lisinopril and nifedipine have neutral effects on lipids].
Both lisinopril and nifedipine effectively lower blood pressure without negatively impacting lipid levels.
RCTEffect of angiotensin converting enzyme inhibitor (lisinopril) on insulin sensitivity and sodium transport in mild hypertension.
Lisinopril treatment reduces blood pressure, improves insulin sensitivity, and reduces sodium transport in young adults with mild hypertension.
RCTLisinopril improves arterial function in hyperlipidaemia.
Lisinopril therapy for 6 months improves arterial function in patients with hyperlipidaemia, potentially reducing mortality and morbidity.
RCTPlasma Lipid Profiles and Antihypertensive Agents: Effects of Lisinopril, Enalapril, Nitrendipine, Hydralazine, and Hydrochlorothiazide
Lisinopril, enalapril, and nitrendipine do not affect plasma lipid concentrations, while hydralazine lowers total and LDL cholesterol.
RCTEffect of lisinopril and perindopril on serum lipid profile in Albino rabbits
Lisinopril improves serum lipid profile by decreasing total cholesterol and increasing HDL levels, while Perindopril increases HDL and decreases LDL levels without significant changes in cholesterol, TG, and VLDL levels.
Angiotensin Converting Enzyme Inhibitor and HMG-CoA Reductase Inhibitor as Adjunct Treatment for Persons with HIV Infection: A Feasibility Randomized Trial
ACE-I therapy may have anti-inflammatory benefits for HIV-infected individuals, but future studies should consider a run-in period and different statin.
RCTSpecific and Pronounced Impacts of Lisinopril and Lisinopril Plus Simvastatin on Erythrocyte Antioxidant Enzymes
Lisinopril and lisinopril + simvastatin both reduce blood pressure and cholesterol, but only lisinopril + simvastatin improves antioxidant enzyme activities in erythrocytes.
RCT
Very Rigorous JournalLisinopril is neutral to insulin sensitivity and serum lipoproteins in essential hypertensive patients
Lisinopril is neutral in its effects on insulin sensitivity, plasma insulin and glucose, and lipoprotein metabolism in patients with essential hypertension.
RCT