Lisinopril heart rate
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Effects of Lisinopril on Heart Rate: A Comprehensive Review
Introduction to Lisinopril and Heart Rate
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used for treating hypertension and heart failure. Its impact on heart rate (HR) and heart rate variability (HRV) has been the subject of various studies, providing insights into its cardiovascular effects.
Lisinopril and Heart Rate Variability in Hypertensive Models
Research on spontaneously hypertensive rats (SHRs) has shown that lisinopril significantly increases heart rate variability (HRV) during both active and inactive periods. This suggests an improvement in autonomic cardio-regulation, although the distribution patterns of R-R intervals varied, indicating complex underlying mechanisms that warrant further investigation.
Lisinopril's Impact on Heart Rate in Hypertensive Patients
In a large multicenter study, lisinopril, both alone and in combination with hydrochlorothiazide, effectively reduced blood pressure without significantly affecting sitting or upright heart rate. This indicates that while lisinopril is potent in managing hypertension, it does not induce reflex tachycardia, a common side effect of many antihypertensive drugs.
Lisinopril in Heart Failure and Atrial Fibrillation
In patients with congestive heart failure and chronic atrial fibrillation, lisinopril improved peak oxygen consumption and tended to lower plasma norepinephrine levels during exercise. However, it did not significantly affect heart rate during exercise or ambulatory monitoring, suggesting that its benefits in this patient group are more related to its antiadrenergic properties rather than direct heart rate modulation.
Comparative Studies: Lisinopril vs. Atenolol and Valsartan
A study comparing lisinopril with atenolol in hemodialysis patients found that while both drugs improved blood pressure control, atenolol was superior in preventing cardiovascular events and hospitalizations. This suggests that while lisinopril is effective, atenolol may offer better cardiovascular protection in this specific patient population.
Another study comparing lisinopril with valsartan in chronic heart failure patients found no significant differences in their effects on heart rate variability and autonomic control. However, valsartan was more effective in reducing plasma norepinephrine levels, indicating a stronger modulation of sympathetic activity.
Acute and Chronic Effects on Reflex Control of Heart Rate
Acute and chronic administration of lisinopril in normotensive individuals showed that it reduced blood pressure without changing heart rate. It also impaired vagally mediated reflexes, such as the diving reflex, suggesting an increase in parasympathetic activity without affecting baroreflexes or sympathetic function.
Hemodynamic and Hormonal Effects in Heart Failure
In patients with heart failure, lisinopril significantly reduced mean arterial pressure and systemic vascular resistance without altering heart rate. This highlights its efficacy in improving hemodynamic parameters while maintaining stable heart rate levels.
Conclusion
Lisinopril is effective in managing hypertension and heart failure, with significant benefits in heart rate variability and autonomic regulation. While it does not significantly alter heart rate in most settings, its impact on sympathetic and parasympathetic balance is noteworthy. Comparative studies suggest that while lisinopril is beneficial, other medications like atenolol and valsartan may offer superior outcomes in specific patient populations. Further research is needed to fully understand the complex interactions between lisinopril and heart rate dynamics.
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