ACE inhibitors, diuretics and zinc deficiency
Type of Spiritual Experience
Backgroundsome background detail on the causes of zinc deficiency
A description of the experience
Int J Clin Pract. 2013 Aug;67(8):717-25. doi: 10.1111/ijcp.12040. Epub 2012 Dec 26. Pharmaco-nutrient interactions - a systematic review of zinc and antihypertensive therapy. Braun LA, Rosenfeldt F. Department of Pharmacy, The Alfred Hospital, Melbourne, Vic., Australia. firstname.lastname@example.org
BACKGROUND: Antihypertensive medicines are to known to cause diverse disturbances to electrolyte homeostasis; however, their potential to affect zinc is less well known. The primary aim was to explore whether antihypertensive medicines have the potential to affect zinc status.
METHODS: A review of electronic databases was undertaken. Full-length English language articles describing clinical trials involving antihypertensive medicines and reporting on zinc measurements were reviewed.
RESULTS: Eight eligible studies were identified which involved the use of ACE inhibitors, thiazide diuretics, beta blockers, or ARB drugs of which five included a control group.
Studies used urinary zinc excretion, plasma zinc levels or erythrocyte zinc as key measures of zinc status.
Studies reported increased urinary zinc losses for captopril (from 50 mg/day), enalapril (20 mg/day), losartan (50 mg/day), losartan (50 mg/day) together with hydrochlorothiazide (12.5 mg/day), captopril (75 mg/day) together with frusemide (40 mg/day) and stand-alone hydrochlorothiazide (25 mg/day).
Serum levels of zinc decreased with captopril (50-150 mg/day), verapamil (240 mg/day), atenolol (50-150 mg/day) and the combination of losartan (50 mg/day) and hydrochlorothiazide (12.5 mg/day), eryrthrocyte levels decreased with use of valsartan (80 mg/day) and in some studies for captopril, but not for metoprolol (100 mg/day), atenolol (50-150 mg/day), verapamil (240 mg/day), doxazosin (4 mg/day) or amlodipine 10 mg/day). Major limitations were that most studies were small and did not report on dietary zinc intake.
CONCLUSION: The available evidence suggests that use of ACE inhibitors and angiotensin 2 receptor antagonists or thiazide diuretics have the potential to reduce zinc levels in hypertensive patients. Additional research using larger participant numbers and accounting for dietary zinc intakes are required.
© 2012 John Wiley & Sons Ltd.