Will lisinopril lower heart rate
Pro Research Analysisby 
Searched over 200M research papers
The Impact 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 managing hypertension and heart failure. While its efficacy in lowering blood pressure is well-documented, its effects on heart rate are less clear. This article synthesizes findings from multiple studies to determine whether lisinopril lowers heart rate.
Lisinopril and Heart Rate Variability
Heart Rate Variability in Hypertensive Rats
A study 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. However, the R-R interval durations, which are indicative of heart rate, demonstrated variable distribution patterns, suggesting that while HRV improved, the direct impact on heart rate was inconsistent.
Clinical Studies on Lisinopril and Heart Rate
Antihypertensive Effectiveness in Humans
A large multicenter study involving patients with mild to moderate hypertension found that lisinopril, both alone and in combination with hydrochlorothiazide, effectively lowered blood pressure without significantly affecting heart rate. This suggests that while lisinopril is effective in managing blood pressure, it does not necessarily lower heart rate in hypertensive patients.
Hemodynamic Effects in Heart Failure
In patients with congestive heart failure, lisinopril administration resulted in significant reductions in mean arterial pressure and systemic vascular resistance but did not lead to significant changes in heart rate. This indicates that lisinopril's primary hemodynamic benefits do not extend to heart rate reduction in heart failure patients.
Sympathetic Heart Rate Response Post-Myocardial Infarction
A study investigating the effect of lisinopril on sympathetic heart rate response during exercise in the early phase of acute myocardial infarction found that while lisinopril improved sympathetic heart rate response, it did not significantly change the heart rate itself. This suggests that lisinopril may enhance the body's ability to regulate heart rate without directly lowering it.
Comparative Studies with Other Medications
Lisinopril vs. Valsartan
When comparing lisinopril with valsartan, another antihypertensive agent, both medications showed similar effects on heart rate variability and autonomic control of heart rate. However, valsartan was more effective in reducing plasma norepinephrine levels, indicating a greater impact on sympathetic activity. This comparison highlights that while lisinopril has beneficial effects on autonomic regulation, it does not significantly lower heart rate compared to other medications.
Combination Therapy with Carvedilol
Adding carvedilol, a beta-blocker, to lisinopril therapy resulted in a significant reduction in heart rate and cardiac workload, unlike when valsartan was added. This suggests that the combination of a beta-blocker with lisinopril is more effective in lowering heart rate than lisinopril alone.
Conclusion
In summary, while lisinopril is effective in lowering blood pressure and improving heart rate variability, it does not significantly lower heart rate on its own. Its primary benefits lie in its ability to enhance autonomic regulation and reduce sympathetic activity, particularly in combination with other medications like beta-blockers. Therefore, for patients specifically seeking heart rate reduction, additional therapies may be required alongside lisinopril.
Sources and full results
Most relevant research papers on this topic