ACE Inhibitor
Summary:
ACE (angiotensin converting enzyme) inhibitors fall into the class of high blood pressure medicines (antihypertensives) used to treat high blood pressure (hypertension).[1] Trandolopril, spiropril and perindopril are ACE inhibitors that can penetrate the blood-brain barrier.[2]
Anatomical studies in animals and humans have shown that there are angiotensin type I receptors in the substantia nigra. People with Parkinson's disease have fewer angiotensin type 1 receptors in their brains. Angiotensin II stimulates the release of newly synthesized dopamine. In examining the relationship between angiotensin type I receptors and people with Parkinson’s disease, a double-blind, placebo-controlled, crossover study demonstrated that after a 4-week treatment period with perindopril (an ACE Inhibitor), “patients had a faster onset in their motor response to levodopa and a reduction in peak dyskinesia.”[3]
Potential benefits:
Risks:
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Possible negative interactions with other medicines
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Lower blood pressure
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Reduced kidney function
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Reduced number of white blood cells, which can lead to serious infections
Obstacles:
Current research:
Seven patients (six women and one man) with moderately severe Parkinson's disease (Hoen and Yahr scale 3) entered a double blind, placebo-controlled crossover study. The results confirmed the concept that an ACE inhibitor can improve the motor response to L-dopa in patients with Parkinson's disease. The drug also increased the proportion of the day spent in the 'on' state, and showed an improvement in the functional disability scale used.[4]
162 people in Japan with mild to moderate Alzheimer's disease and high blood pressure were divided into three groups for a one-year study. Each group of trial participants received either a brain-penetrating ACE inhibitor, a non-brain-penetrating ACE inhibitor, or another type of blood pressure drug. Trial participants in the brain-penetrating ACE inhibitor groups received one of two drugs - perindopril or captopril. The study showed that those who were on a brain-penetrating ACE inhibitor showed less decline in memory than the other trial participants.[5]
[1] Angiotensin-converting Enzyme (ACE) Inhibitors; Retrieved date: March 13, 2005
[2] A new approach to treating Parkinson's disease? ..Summarized by Robert W. Griffith, MD, January 30, 2001 (Reviewed: February 18, 2003)
[3] Potential Noncardiac, Nonrenal Uses of Angiotensin; from Medscape Pharmacotherapy, Retrieved date: March 13, 2005
[4] A new approach to treating Parkinson's disease? Summarized by Robert W. Griffith, MD
January 30, 2001 (Reviewed: February 18, 2003)
[5] Medical News Today; Blood Pressure Drugs May Slow Deterioration of Alzheimer's, 12 Oct 2004
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