Side effects of lisinopril in males
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Side Effects of Lisinopril in Males
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed for hypertension and heart failure. While effective, it is important to understand its potential side effects, particularly in male patients.
Hormonal Changes in Males
Decrease in Plasma Free Testosterone
One significant side effect of lisinopril in males is its impact on hormonal levels. Research indicates that lisinopril can significantly decrease plasma free testosterone (f-T) concentrations in male hypertensive patients. In a study, the f-T concentration dropped from 13.8±2.4 pg/ml to 9.9±1.5 pg/ml after six months of treatment with lisinopril . This reduction in free testosterone could have various implications, including potential effects on libido and overall energy levels.
Cardiovascular Effects
Blood Pressure and Heart Rate
Lisinopril is effective in lowering blood pressure, but it can also influence heart rate. In a study involving healthy male volunteers, lisinopril, when combined with nifedipine, caused an additive effect on lowering blood pressure and an increase in heart rate during the first four hours post-administration . Additionally, lisinopril impaired the vagally mediated early cardiac acceleration associated with lying down, indicating an effect on reflex control of heart rate .
Reflex Control of Heart Rate
Further studies have shown that lisinopril can attenuate bradycardia induced by facial immersion (diving reflex), which is a parasympathetically mediated response. This suggests that lisinopril may increase parasympathetic activity without impairing baroreflexes or sympathetic function .
Reproductive Health
Effects on Sperm Quality
Interestingly, lisinopril may have beneficial effects on male reproductive health. A pilot study on normotensive men with idiopathic oligospermia found that low-dose lisinopril (2.5 mg/day) improved sperm quantity and quality. The study reported an increase in total sperm cell count and the percentage of motile sperm cells, along with a decrease in the percentage of sperm cells with abnormal morphology. The pregnancy rate among partners of the participants was 48.5%, indicating a potential positive impact on fertility .
Conclusion
Lisinopril, while effective in managing hypertension and heart failure, has several side effects in males. These include a significant decrease in plasma free testosterone levels, alterations in heart rate and reflex control, and potential improvements in sperm quality and fertility. Understanding these side effects is crucial for healthcare providers to manage and mitigate risks while optimizing therapeutic outcomes for male patients.
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