Effects of ACE Inhibitor (Lisinopril) with Folic Acid Supplementation in the Management of Hypertension Associated with Hyperuricemia
Asif Aziz
Department of General Medicine, Gambat Medical College, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Pakistan.
Sarwat Ashraf
Department of General Medicine, Gambat Medical College, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Pakistan.
Ali Akber Nangraj
Department of General Medicine, Liaquat University Hospital Hyderabad / Jamshoro, Pakistan.
Ali Raza Memon
Department of Biochemistry, Liaquat University of Medical and Health Sciences, Pakistan.
Madiha Shah
Department of General Medicine, Liaquat University of Medical and Health Sciences, Pakistan.
Razia Bano
Department of General Medicine, Liaquat University of Medical and Health Sciences, Pakistan.
Salman Shams *
Department of Oral Medicine, Faculty of Dentistry, Liaquat University of Medical and Health Sciences, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Background: Hypertension is one of the leading cause of morbidity and mortality in all over the world as in developed and under developing countries. Hypertension mostly associated with other clinical chronic disorders like diabetes mellitus, hyperuricemia, dyslipidemia etc. The ACE inhibitors are a kind of antihypertensive drug that is widely using all over the world. ACE inhibitors lowers blood pressure, but also lower uric acid levels as well.
Aims & Objectives: To evaluate the efficacy of ACE inhibitors alone and along with the folic acid on systolic & diastolic blood pressure & on serum uric acid level.
Methodology: This case-control research was carried out at the Medicine Department with the help of the Department of Biochemistry at LUMHS Jamshoro and the PAQSJ Medical Institute in Gambat. A total of 200 mild to moderate hypertension individuals with hyperuricemia were chosen. They were divided into two groups: the control group was taken 10 mg of lisinopril, while the case study group received 10 mg of lisinopril with 0.8 mg of folic acid for 10 to 12 weeks.
Results: The mean value of systolic B.P in control group after treatment was126 ± 4.9 (P<0.05) while in case study group after treatment was 118 ± 6.12 mmHg (P<0.05). Diastolic B.P in control group after treatment was 90 ± 4.76 mmHg while in case study group was 82.3 ± 3.66 mmHg (P<0.05). The serum uric acid level after treatment in control group was 6.7 ± 4.78 mg/dl while in case study group, it was 5.5 ± 5.11 mg/dl (P<0.001). Serum Folic acid levels after the treatment in control group was 12.31 ± 2.89 while in case study group it was 27.09 ± 3.47 nmol/L (P<0.001).
Conclusion: Folic acid enhances the effectiveness of an ACE inhibitor (lisinopril) and has a substantial influence in the lowering of serum uric acid as therapeutic agent in the cases of mild to moderate hypertension associated with hyperuricemia.
Keywords: Hyperuricemia, ACE inhibitors, hypertension, folic acid, serum uric acid