Lisinopril low heart rate
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Lisinopril and Its Impact on Heart Rate: A Comprehensive Review
Introduction to Lisinopril and Heart Rate
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used for managing hypertension and heart failure. One of the concerns with ACE inhibitors is their potential impact on heart rate. This article synthesizes research findings on the effects of lisinopril on heart rate, particularly focusing on whether it causes a low heart rate.
Lisinopril and Heart Rate in Hypertensive Patients
Several studies have investigated the effects of lisinopril on heart rate in hypertensive patients. A large multicenter study found that lisinopril, both alone and in combination with hydrochlorothiazide, effectively reduced blood pressure without significantly affecting heart rate. This suggests that lisinopril does not typically cause bradycardia (low heart rate) in hypertensive patients.
Heart Rate Variability and Autonomic Regulation
Research on spontaneously hypertensive rats treated with lisinopril for 10 weeks showed a significant increase in heart rate variability (HRV) during both active and inactive periods. Increased HRV is generally considered a positive indicator of autonomic regulation, suggesting that lisinopril may improve autonomic control without causing a low heart rate.
Clinical Pharmacology Insights
Lisinopril's pharmacological profile indicates that it produces a smooth and gradual reduction in blood pressure without affecting heart rate or cardiovascular reflexes. This aligns with findings from other studies that lisinopril does not induce reflex tachycardia or bradycardia, maintaining stable heart rate levels.
Effects in Heart Failure Patients
In patients with congestive heart failure (CHF) and chronic atrial fibrillation, lisinopril improved peak oxygen consumption and attenuated adrenergic drive during exercise without significantly affecting heart rate during exercise and ambulatory monitoring. This indicates that lisinopril can be beneficial in heart failure management without causing adverse changes in heart rate.
Comparative Studies with Other Medications
Comparative studies between lisinopril and other medications, such as valsartan, showed no significant differences in their effects on heart rate variability and autonomic control of heart rate. Both medications effectively reduced plasma norepinephrine levels, with valsartan showing a slightly greater reduction, but neither caused significant changes in heart rate.
Acute and Chronic Effects on Reflex Control
Acute and chronic administration of lisinopril in normotensive individuals demonstrated that while it reduced blood pressure, it did not significantly alter heart rate or impair baroreflexes and sympathetic function. This further supports the notion that lisinopril does not cause a low heart rate.
Conclusion
Overall, the evidence suggests that lisinopril is effective in managing hypertension and heart failure without causing significant changes in heart rate. It improves heart rate variability and autonomic regulation, which are beneficial for cardiovascular health. Therefore, concerns about lisinopril causing a low heart rate appear to be unfounded based on current research.
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