Lisinopril names
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Lisinopril: Names and Clinical Applications
Lisinopril Names and Brand Variants
Lisinopril is a widely used angiotensin-converting enzyme (ACE) inhibitor that helps relax blood vessels and reduce blood pressure. It is marketed under several brand names, including Prinivil®, Qbrelis®, and Zestril®. Additionally, lisinopril is available in combination with the diuretic hydrochlorothiazide under the brand name Zestoretic®.
Clinical Efficacy and Applications
Hypertension Management
Lisinopril is effective in managing high blood pressure (hypertension). Studies have shown that it can significantly reduce both systolic and diastolic blood pressure in patients with mild to moderate essential hypertension. The drug is often compared with hydrochlorothiazide (HCTZ) and their combination (LIS + HCTZ), with the combination therapy showing superior efficacy in blood pressure control.
Heart Failure and Post-Myocardial Infarction
Lisinopril is also beneficial for patients with congestive heart failure and those recovering from a myocardial infarction. It improves exercise duration, enhances left ventricular ejection fraction, and reduces mortality and left ventricular dysfunction when administered shortly after a heart attack. The GISSI-3 trial demonstrated that lisinopril is effective in reducing mortality and improving heart function in both elderly and younger patients post-myocardial infarction.
Diabetic Nephropathy
For patients with diabetic nephropathy, lisinopril helps in controlling blood pressure and reducing albuminuria, which is a marker of kidney damage. This effect is comparable to other antihypertensive agents like diltiazem, nifedipine, and verapamil, and superior to atenolol. Lisinopril may also offer additional benefits in reducing mortality and improving neuropathy in diabetic patients.
Mechanisms and Additional Effects
ACE Inhibition and Blood Pressure Control
Lisinopril works by inhibiting the angiotensin-converting enzyme, which leads to the relaxation of blood vessels and a decrease in blood volume, thereby lowering blood pressure. It is a lysine analog of enalaprilat and is not a prodrug, which means it is active in its administered form and has a slightly longer duration of action compared to enalapril.
Impact on ACE2 Levels
Recent studies have explored the impact of lisinopril on ACE2 levels, the receptor for SARS-CoV-2. Oral administration of lisinopril has been shown to increase ACE2 protein levels in various tissues, which could have implications for COVID-19 transmission and pathogenesis. However, the combination of lisinopril with losartan, an angiotensin receptor blocker, does not increase ACE2 levels and may even reduce them.
Conclusion
Lisinopril is a versatile and effective ACE inhibitor used under various brand names such as Prinivil®, Qbrelis®, and Zestril®. It is highly effective in managing hypertension, heart failure, and post-myocardial infarction conditions, and offers additional benefits for patients with diabetic nephropathy. Its impact on ACE2 levels also opens new avenues for research, particularly in the context of COVID-19.
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