Many medicines are designed for one purpose but are later found to have positive effects on several other ailments. The hypertension drug lisinopril is one such medicine.
This drug has been used for decades to treat hypertension. During that time, doctors discovered several other benefits to their patients due to taking the drug, for example, improved kidney function.
Let's take a look at what lisinopril is, how it helps the kidneys, and what other benefits come with it.
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Lisinopril belongs to a class of medications known as ACE inhibitors.¹
There are hormones in your body known as angiotensin I and angiotensin II. The latter acts as a powerful vasoconstrictor, constricting the walls of your blood vessels and increasing the blood pressure within them.
In people with normal blood pressure, this isn't a problem. For those with high blood pressure, preventing this action can help to reduce the pressure.
ACE inhibitors block the effects of an enzyme, angiotensin-converting enzyme (ACE), that converts angiotensin I to angiotensin II. By reducing the amount of angiotensin II in the system, they help to reduce blood pressure as well.
One of the FDA-approved uses of lisinopril is to improve health outcomes in patients with chronic kidney disease (CKD). The FDA recommends a drug like lisinopril as part of the initial therapy for kidney patients.
Angiotensin II, which is reduced with ACE inhibitors, plays a role in kidney function. Overactivity of the hormone in the kidney can worsen CKD, among other conditions.
Therefore, hypertension drugs that work by reducing the amount of angiotensin II in the body also help to improve kidney function in those with or at risk of CKD.
Drugs that reduce the effects of angiotensin II in the kidneys include ACE inhibitors like lisinopril and angiotensin receptor blockers (ARBs) like losartan.
Besides its use for high blood pressure and kidney function, there are two categories of uses for lisinopril: those approved by the FDA (on-label) and those that aren't (off-label).
The safety of drugs like lisinopril means that off-label uses² outside of FDA testing are safe alternatives if the doctor has reason to believe that the drug will aid the problem being treated.
Continue reading for some of the other ailments that lisinopril treats, both on-label and off-label.
Therapy for heart failure: ACE inhibitors such as lisinopril may be used in therapy after or in certain patients as part of heart failure prevention therapy.
Treating coronary artery disease: For patients with a history of left ventricular dysfunction, diabetes mellitus, or CKD, ACE inhibitors are recommended as part of the treatment plan for coronary artery disease.
Improving outcomes after a heart attack: An ST-elevated myocardial infarction (STEMI) is one of the most dangerous types of heart attack. Doctors should start such patients on ACE inhibitors within 24 hours of the attack. The medicine is known to reduce mortality rates.
Preventing migraine: Lisinopril has been shown to reduce the time that migraine headaches last and how often they occur. Each of these measurements was reduced by about 20% compared to the placebo.
Decreasing diabetes risk: Because lisinopril has been shown to increase insulin sensitivity, it's been used as an effective treatment for the prevention of diabetes. Several studies have repeated the results.
Slowing diabetic eye disease: For patients who develop retinopathy due to diabetes, lisinopril has shown promise as a treatment. Compared to a placebo group, diabetic retinopathy patients on lisinopril saw the progression of their retinopathy halved and the chances of progression reduced.
Treating various heart conditions: Several heart conditions can also benefit from lisinopril. Among the conditions studied are myocardial fibrosis, mitral incompetence, and cardiomyopathy in patients with Duchenne muscular dystrophy. Each of these conditions was shown to improve with lisinopril usage.
Increasing male fertility: Men with idiopathic oligospermia were studied to see if lisinopril would improve their fertility. Among the men studied, 53.6% saw their sperm parameters return to normal levels. Both sperm count and the number of abnormal sperm cells were improved in the lisinopril group.
Although lisinopril was originally designed as a hypertension drug to help lower blood pressure, the beneficial effects of blocking angiotensin II have been shown to extend beyond hypertension patients. There are now many established uses for lisinopril, both on-label and off-label.
Because angiotensin II plays a role in kidney function, and people with CKD may find themselves with too much angiotensin II activity, ACE inhibitors such as lisinopril are also known to help prolong kidney function. If you think you may have kidney disease, talk to your doctor about your symptoms.
Certain classes of blood pressure medication are known to help those who already have kidney problems. ACE inhibitors, such as lisinopril and angiotensin receptor blockers (ARB), reduce the negative effects of angiotensin II in the kidneys.
Additionally, high blood pressure can have damaging effects on the kidneys, so medications that get it under control can help protect them.
The most common side effects of lisinopril are mild and include:
Decrease in sexual function
If you've prescribed lisinopril, as with any drug, read the information packet to know which side effects you should alert your doctor.
ACE inhibitors | NIH: National Library of Medicine