Obesity combined with hypertension: How can ACE inhibitors assist in scientific weight loss?

Drug Therapy: Human blood pressure is affected by many factors. Any disruption to any part or link in the blood pressure regulation system can cause changes in blood pressure. Antihypertensive drugs work by acting on one or more parts of the blood pressure regulation system. Based on their primary site of action, antihypertensive drugs are classified into diuretics, sympathetic nerve inhibitors, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers, and vasodilators.

Angiotensin-Converting Enzyme Inhibitors (ACEIs):

1. Pharmacological Action: ACEIs compete with Ang I (angiotensin I) or bradykinin (BK) for ACE, binding to and inhibiting its activity, preventing the conversion of Ang I to Ang II (angiotensin II). This leads to peripheral vasodilation and a decrease in total peripheral resistance. Simultaneously, ACEIs reduce bradykinin degradation, increasing blood bradykinin concentration. Bradykinin can cause vasodilation through the release of NO and hyperpolarizing factors from vascular endothelial cells.

2. Drugs and Antihypertensive Use

Captopril (Captopril): Oral administration, 12.5–25 mg once, 2–3 times daily. The main adverse reaction is frequent dry cough with long-term use, occurring in 5%–20% of patients. Other side effects include rash, loss of taste, neutropenia, and proteinuria. Contraindicated in patients with bilateral renal artery stenosis.

Enalapril (Enalapril): Oral administration, 2.5–10 mg once daily. This drug has 20 times stronger inhibitory effects on angiotensin-converting enzyme than captopril, with a duration of action up to 24 hours, and fewer adverse reactions than captopril.

Lisinopril (Lisinopril): Oral administration, 5–20 mg once daily.

Perindopril: Oral administration, 4-8 mg once daily.

Benazepril: Oral administration, 10 mg once daily.

Fosinopril (Mono): Oral administration, 10-20 mg once daily. Fosinopril has dual hepatic and renal clearance; in patients with impaired liver or kidney function, medication adjustment is generally not required.