Lisinopril evaluation of medication effectiveness
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Evaluation of Lisinopril's Effectiveness as a Medication
Introduction to Lisinopril Effectiveness
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used to manage hypertension, congestive heart failure, and acute myocardial infarction. This article synthesizes research findings on the effectiveness of lisinopril across various patient demographics and conditions.
Lisinopril in Hypertensive Children
Pediatric Hypertension Management
A controlled study evaluated lisinopril's dose-response relationship and safety in 115 hypertensive children aged 6 to 16 years. The study found a clear dose-response relationship, with higher doses leading to more significant reductions in blood pressure (BP). Lisinopril was effective in lowering BP within two weeks, and the effect was consistent across different subgroups, including age, Tanner stage, ethnicity, and gender .
Lisinopril in Elderly Patients
Hypertension and Heart Failure
Lisinopril has been shown to be effective in elderly patients with hypertension. In clinical trials, 68.2% to 89.1% of elderly patients responded to lisinopril treatment, achieving diastolic pressures of ≤90 mm Hg. The drug was also effective in improving exercise duration and left ventricular ejection fraction in patients with congestive heart failure . Another study confirmed that lisinopril significantly increased exercise tolerance and improved left ventricular function in elderly patients, showing similar efficacy to captopril .
Long-Term Efficacy and Tolerability
A 12-week study involving elderly patients demonstrated that lisinopril effectively reduced mean sitting BP from 190/106 mm Hg to 162/89 mm Hg without significant alterations in heart rate or renal function. The drug was well tolerated, with renal function preserved over two years of treatment .
Lisinopril in Obese Hypertensive Patients
Comparative Efficacy with Hydrochlorothiazide
In a 12-week multicenter trial, lisinopril was compared with hydrochlorothiazide in 232 obese hypertensive patients. Both medications effectively lowered BP, but lisinopril showed a slightly higher efficacy in reducing diastolic pressure. Additionally, lisinopril had a more favorable impact on plasma glucose levels compared to hydrochlorothiazide, which increased plasma glucose significantly .
Lisinopril in Acute Myocardial Infarction
Mortality and Ventricular Function
The GISSI-3 trial, involving over 19,000 patients, demonstrated that lisinopril, when administered within 24 hours of acute myocardial infarction (AMI) symptoms, significantly reduced overall mortality and severe ventricular dysfunction. The benefits were evident within 1 to 2 days of starting treatment and persisted for up to six months 89.
Antiproteinuric Effects of Lisinopril
Proteinuria Management
Lisinopril has also been effective in reducing proteinuria in patients with varying degrees of renal function. A study showed that lisinopril reduced proteinuria by 50% at higher doses, and this effect was dependent on dietary sodium restriction. The antiproteinuric effect was comparable to that of indomethacin but with fewer adverse effects .
Conclusion
Lisinopril is a versatile and effective medication for managing hypertension, heart failure, and acute myocardial infarction across various patient demographics. Its benefits include significant BP reduction, improved cardiac function, and reduced mortality in high-risk patients. The drug is well tolerated, with a safety profile typical of ACE inhibitors. These findings underscore lisinopril's role as a critical component in the management of cardiovascular and renal conditions.
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