Lisinopril is part of the ACE inhibitors drug class. Compared to other drugs within the same class such as captopril and enalapril, lisinopril has a longer duration of action. FDA-approved Indications:
Lisinopril is approved by the US Food and Drug Administration (FDA) to manage hypertension in adult and pediatric patients six years and older. as adjunctive therapy in the treatment of heart failure. It is recommended as a treatment of ST-segment elevation myocardial infarction (STEMI) within 24 hours in hemodynamically stable patients to improve survival.The lisinopril is started at 5 or 10 mg and titrated upwards to 40 mg once daily maximum. The usual effective maintenance dosage is 20mg administered in a single daily dose.A review concluded that lisinopril was effective for treatment of proteinuric kidney disease, including diabetic proteinuria.In people of sub-Saharan African descent, calcium-channel blockers or thiazide diuretics may more effectively lower blood pressure than ACE inhibitors such as lisinopril, although convincing evidence is lacking that these drugs differ in their effect on morbidity or mortality in such persons. Kidney problems
In patients with moderate to severe kidney disease, lisinopril and other ACE inhibitors are superior to angiotensin II receptor blockers and other antihypertensive drugs for prevention of death, fatal cardiac events, and kidney injury. Dose reduction may be required when creatinine clearance is less than or equal to 30mL/min. Since lisinopril is removed by dialysis, dosing changes must also be considered for people on dialysis.
Chronic mountain sickness (CMS) is a disease in which the proportion of blood volume that is occupied by red blood cells increases (polycythaemia) and there is an abnormally low level of oxygen in the blood (hypoxemia). CMS typically develops after extended time living at high altitude (over 2,500 metres (8,200 ft)). It is most common amongst native populations of high altitude nations. The most frequent symptoms of CMS are headache, dizziness, tinnitus, breathlessness, palpitations, sleep disturbance, fatigue, loss of appetite, confusion, cyanosis, and dilation of veins.CMS was first described in 1925 by Carlos Monge Medrano, a Peruvian doctor who specialised in diseases of high altitude. While acute mountain sickness is experienced shortly after ascent to high altitude, chronic mountain sickness may develop only after many years of living at high altitude. In medicine, high altitude is defined as over 2,500 metres (8,200 ft), but most cases of CMS occur at over 3,000 metres (9,800 ft). It has recently been correlated with increased expression of the genes ANP32D and SENP1. Diagnosis
CMS is characterised by polycythaemia (with subsequent increased haematocrit) and hypoxaemia; raised blood pressure in the lungs (pulmonary hypertension) can develop over time and in some cases progress to heart failure (cor pulmonale). CMS is believed to arise because of an excessive production of red blood cells (erythrocytes) due to the low oxygen levels at altitude, which increases the oxygen carrying capacity of the blood[1]. The increased levels of erythrocytes causes increased blood viscosity and uneven blood flow through the lungs (V/Q mismatch).