EFFECT OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS ON SERUM AMYLASE AND LIPASE IN PATIENTS WITH HYPERTENSION

Introduction: Angiotensin-converting enzyme (ACE) inhibitors are a class of potential drugs used as first-line agents for the treatment of hypertension and heart failure in physiologically young patients despite its side effects. Apart from the other common side effects, they are known to induce bradykinin release which alters vascular permeability leading to pancreatic edema resulting in intrapancreatic entrapment of enzymes, toxins and acute pancreatitis. Objective: To determine the effect of long term ACE inhibitors use on serum amylase and lipase levels. Methods: A total of 122 patients were divided into two groups as case and control group, were case group the patients using ACE inhibitors for more than 8 months, and control group is the patients who are on other antihypertensive. Pancreatic enzyme levels were measured by ELISA method, and the elevation of pancreatic enzymes was determined in both the group and compared by Unpaired T-test. Results: Study showed a significant difference in amylase levels between case and control groups (P≤0.002) and Lipase level among case and control groups (P≤0.003). Further, confounding factors were adjusted on ACE inhibitor usage. Conclusion: The use of ACE inhibitors showed a significant association with elevated serum amylase and lipase levels in hypertensive patients. Our study suggests the monitoring of serum amylase and lipase levels in patients who are on ACE-inhibitors and its administration must be stopped as soon as an increase of serum amylase and lipase is evident for causing acute pancreatitis.