Zinc Metabolism during Captopril Treatment

Zumkley, H; Hp, Bertram; Vetter, Hans; Zidek, Walter; Losse, H

doi:10.1055/s-2007-1013508

Cited by 23 publications

(11 citation statements)

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“…It was found that plasma zinc concentration decreased whereas intraerythrocytic zinc concentrations increased slightly in 14 hypertensive patients treated with captopril [31].…”

Section: Angiotensin-converting Enzyme (Ace) Inhibitors and Angiotensmentioning

confidence: 98%

Zinc balance and medications commonly used in the management of heart failure

Cohen

Golik

2006

Heart Fail Rev

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Heart failure (HF) is a prevalent syndrome resulting in a high mortality rate. HF may be associated with zinc deficiency through a reduction in dietary intake, decreased absorption due to gastrointestinal edema, impaired motility or intestinal zinc losses. Diseases concomitant with HF such as diabetes mellitus (DM) and hypertension may enhance zinc deficiency. Medications given for HF may affect zinc metabolism in different ways. It was shown that thiazides may cause zincuria and a decrease in tissue zinc concentration. There is conflicting evidence about furosemide, even though patients with chronic furosemide treatment showed low tissue zinc levels in autopsies. Treatment with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) resulted in zincuria and zinc deficiency, but this outcome was not consistent in all studies. Beta-blockers did not alter plasma zinc concentration. Matrix metalloproteinases (MMPs) and ACE are zinc-containing enzymes, which play a role in the process of remodeling in HF. It was shown that ACE inhibitors may inhibit the activity of different MMPs. The exact interrelationship between HF, zinc-containing enzymes, zinc deficiency and the clinical manifestation of HF has to be investigated.

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“…It was found that plasma zinc concentration decreased whereas intraerythrocytic zinc concentrations increased slightly in 14 hypertensive patients treated with captopril [31].…”

Section: Angiotensin-converting Enzyme (Ace) Inhibitors and Angiotensmentioning

confidence: 98%

Zinc balance and medications commonly used in the management of heart failure

Cohen

Golik

2006

Heart Fail Rev

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“…[34][35][36][37] Of interest, urinary Zn excretion is increased in response to treatment with angiotensinconverting enzyme inhibitor or angiotensin receptor antagonist and where hypozincemia is held responsible for the appearance of disturbances of taste. [38][39][40][41] In recent studies conducted in Memphis in middle-aged African-American patients having a dilated cardiomyopathy of uncertain etiology, reductions in serum Zn and Se were found and included those patients hospitalized with decompensated failure and outpatients with compensated failure. Specifically, serum Zn was below normal range (75-140 μg/dl) in 11 of 15 patients with protracted CHF (67 ± 5; 47-107 μg/dl), 8 of 10 patients with 1-week to 2-weeks CHF (65 ± 4; 43-79 μg/dl) and 5 of 6 patients with compensated failure (70 ± 2; 63-79 μg/dl).…”

Section: Chf: a Salt-avid Statementioning

confidence: 99%

Congestive Heart Failure is a Systemic Illness: A Role for Minerals and Micronutrients

Alsafwah¹,

LaGuardia²,

Arroyo³

et al. 2007

Clinical Medicine & Research

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Congestive heart failure (CHF) is a clinical syndrome that features a failing heart together with signs and symptoms arising from renal retention of salt and water, mediated by attendant neurohormonal activation, and which prominently includes the renin-angiotensin-aldosterone system. More than this cardiorenal perspective, CHF is accompanied by a systemic illness whose features include an altered redox state in diverse tissues and blood, an immunostimulatory state with proinflammatory cytokines and activated lymphocytes and monocytes, and a wasting of tissues that includes muscle and bone. Based on experimental studies of aldosteronism and clinical findings in patients with CHF, there is an emerging body of evidence that secondary hyperparathyroidism is a covariant of CHF. The aldosteronism of CHF predisposes patients to secondary hyperparathyroidism because of a chronic increase in Ca 2+ and Mg 2+ losses in urine and feces, with a fall in their serum ionized levels and consequent secretion of parathyroid hormone. Secondary hyperparathyroidism accounts for bone resorption and contributes to a fall in bone strength that can lead to nontraumatic fractures. The long-term use of a loop diuretic with its attendant urinary wasting of Ca 2+ and Mg 2+ further predisposes patients to secondary hyperparathyroidism and attendant bone loss. Aberrations in minerals and micronutrient homeostasis that includes Ca 2+ , Mg 2+ , vitamin D, zinc and selenium appear to be an integral component of pathophysiologic expressions of CHF that contributes to its systemic and progressive nature. This broader perspective of CHF, which focuses on the importance of secondary hyperparathyroidism and minerals and micronutrients, raises the prospect that dietary supplements could prove remedial in combination with the current standard of care.

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“…In this connection, urinary Zn excretion is increased in aldosteronism [78], hyperparathyroidism [79][80][81], and during treatment with either an ACE inhibitor or AT 1 receptor antagonist treatment [82][83][84][85][86][87].…”

Section: Congestive Heart Failure An Overviewmentioning

confidence: 99%

“…Therefore, it is not surprising that hypozincemia has been reported in patients with a dilated cardiomyopathy [139][140][141]. Of interest, urinary Zn excretion is increased in response to ACE inhibitor or ARB treatment, but not a loop diuretic, and has been held responsible for the appearance of hypozincemia and associated impairment in taste (dysgeusia) reported in patients with CHF treated with these agents [82][83][84][85][86]. A redistribution and/or elimination of trace minerals from tissues has also been reported in response to captopril [86,87].…”

Section: Micronutrient Deficiencies and Oxidative Stress In Aldosteromentioning

confidence: 99%

Macro- and micronutrients in African-Americans with heart failure

et al. 2006

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An emerging body of evidence suggests secondary hyperparathyroidism (SHPT) may be an important covariant of congestive heart failure (CHF), especially in African-Americans (AA) where hypovitaminosis D is prevalent given that melanin, a natural sunscreen, mandates prolonged exposure of skin to sunlight and where a housebound lifestyle imposed by symptomatic CHF limits outdoor activities and hence sunlight exposure. In addition to the role of hypovitaminosis D in contributing to SHPT is the increased urinary and fecal losses of macronutrients Ca(2+) and Mg(2+) associated with the aldosteronism of CHF and their heightened urinary losses with furosemide treatment of CHF. Thus, a precarious Ca(2+) balance seen with reduced serum 25(OH)D is further compromised when AA develop CHF with circulating RAAS activation and are then treated with a loop diuretic. SHPT accounts for a paradoxical Ca(2+) overloading of diverse tissues and the induction of oxidative stress at these sites which spills over to the systemic circulation. In addition to SHPT, hypozincemia and hyposelenemia have been found in AA with compensated and decompensated heart failure and where an insufficiency of these micronutrients may have its origins in inadequate dietary intake, altered rates of absorption or excretion and/or tissue redistribution, and treatment with an ACE inhibitor or AT(1) receptor antagonist. Zn and Se deficiencies, which compromise the activity of several endogenous antioxidant defenses, could prove contributory to the severity of heart failure and its progressive nature. These findings call into question the need for nutriceutical treatment of heart failure and which is complementary to today's pharmaceuticals, especially in AA.

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Zinc Metabolism during Captopril Treatment

Cited by 23 publications

References 0 publications

Zinc balance and medications commonly used in the management of heart failure

Zinc balance and medications commonly used in the management of heart failure

Congestive Heart Failure is a Systemic Illness: A Role for Minerals and Micronutrients

Macro- and micronutrients in African-Americans with heart failure

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