Lisinopril is a blood pressure lowering drug from the group of ACE inhibitors. It is mainly used to treat high blood pressure and heart failure. Lisinopril works by reducing the water retention of the kidneys and dilating the vessels. This is achieved by inhibition of the angiotensin converting enzyme (ACE), which induces a narrowing of the vessels (vasoconstriction) and increased water absorption via the kidneys by the formation of angiotensin 2. ACE inhibitors are currently the first choice for treating high blood pressure.
Indication
Lisinopril has other uses besides the treatment of hypertension and symptomatic heart failure. Immediately after a heart attack it has been shown that taking lisinopril for a few weeks can reduce the risk of another heart attack. ACE inhibitors also have a protective effect on the kidney, so that lisinopril is also prescribed to patients with diabetes, such as those with high blood pressure and nephropathy.
Application
Lisinopril is taken by patients in tablet form. Usually one tablet containing 10 to 40 mg of active ingredient is prescribed once a day. In hypertension therapy, Lisinopril can be combined with other drugs to achieve a better effect, for example diuretics and calcium antagonists. The combination of lisinopril and diuretics is also used in heart failure therapy and may be supplemented with a beta-blocker, digitalis or other drugs.
Mode of action
The action of Lisinopril is based on the inhibition of the angiotensin converting enzyme (ACE). This is part of the renin-angiotensin-aldosterone system (RAAS), a hormonal control circuit that regulates the water and electrolyte balance. The first step in the RAAS’ control circuit takes place in the kidney, where specialized cells measure blood pressure.
If the pressure drops, the enzyme renin is released in the kidney. Renin cleaves angiotensinogen to angiotensin 1, which is then split by the ACE to the biologically active angiotensin 2. Angiotensin 2 triggers vasoconstriction and the release of hormones with blood pressure-lowering and water-retaining effects.
If the ACE is now inhibited by lisinopril, there is a reduced release of these hormones and the blood vessels are no longer contracted. Due to the reduced vasoconstriction, the volume of the vascular system and thus also its pressure decreases. The reduced water retention results in a reduced blood volume, which is also noticeable in a reduced blood pressure.
When the blood is pumped through the body, the heart has a lower pressure and volume load. This is used in the therapy of heart failure, the heart is protected by taking ACE inhibitors such as Lisinopril. Angiotensin 2 also increases the breakdown of muscle cells and the scarring of tissue in cases of insufficient blood supply to the heart muscle, as is the case in myocardial infarction, for example. To stop this process, Lisinopril is also prescribed after heart attacks.
