ACEI Relation with Cardiac Enzyme CK-MB Levels in Hypertensive Patients

Abstract

Captopril is one of ACEI (Angioten Converting Enzyme Inhibitor). It is widely used for treatment of hypertension as effective and safe antihypertensive drug. But long term usage of Captopril may cause one of the cardiovascular diseases like myocardial infarction. To prove the relationship between Captopril and cardiovascular disease, measurement of creatine-kinase-MB as a diagnostic indicator in early and long term usage of this drug by hypertensive patients is recommended.A comparative study was conducted in Al-Yarmouk Teaching Hospital-Emergency Department- on 24 hypertensive patients using Captopril. They were divided into (2) groups A and B according to the duration of the drug usage. Group A (12) patients with a mean age (51) years. They used Captopril for a period of (1-5) years. Group B also (12) patients with mean age (56) years. They used Captopril for (6-12) years. Both groups were with nearly the same number of males and females. Venous blood samples were taken in first 8 hours after onset symptoms of cardiac attack from each patient and the levels of creatine kinase-MB were estimated and compared between the two groups. There is significant correlation between levels of serum creatine kinase-MB of group A and group B (p<0.05). Captopril causes increased level of serum CK-MB and this increase was directly proportional to the duration of the drug usage CK-MB the specific marker for cardiovascular diseases. So, Captopril has a significant correlation with development of cardiovascular diseases. A comparative study with another antihypertensive drug Atenolol taken by a group of (24) patients using Atenolol for 1-12 years, showed a significant correlation between levels of serum CK-MB of the two groups of patients using Atenolol for a period of (1-5) years and (5-12) years (p<0.05). Non-significant correlation between levels of serum CK-MB of the two groups of patients that use Captopril and Atenolol for (1-5) years (p=0.085). A significant correlation between levels of serum CK-MB of the two groups of patients that use Captopril and Atenolol for (6-12) years (p<0.05). Captopril showed less effect on levels of CK-MB than Atenolol did. Key words: hypertension, Captopril, ACEI, creatine kinase-MB, Captopril antihypertensive, Atenolol antihypertensive.