Long-Term Use of ACE Inhibitors May Cause Kidney Damage, Study Results Suggest

New research raises concerns about the commonly prescribed medications used to treat heart failure and high blood pressure, though investigators say patients should continue to take them.

New research from the University of Virginia (UVA) School of Medicine raises concerns about the long-term use of commonly prescribed medications used to treat heart failure and high blood pressure (BP) and how they may contribute to kidney damage.­­­­1

However, investigators say patients should continue to take the potentially life-saving medications, which include well-known and widely used angiotensin-converting enzyme (ACE) inhibitors) while research to better understand the long-term effects of the drugs continues.1

“Our studies show that renin-producing cells are responsible for the damage. We are now focusing on understanding how these cells, which are so important to defend us from drops in blood pressure and maintain our well-being, undergo such transformation, and induce kidney damage,” Maria Luisa Sequeira-Lopez, MD, of UVA’s department of pediatrics and child health research center, said in a statement.1

“What is needed is to identify what substances these cells make that lead to uncontrolled vessel growth,” she said.1

Investigators found that specialized kidney cells called renin cells play an important role in organ damage. The cells normally produce renin, which is a vital hormone that helps the body regulate BP, but harmful changes in the renin cells can cause the cells to invade the walls of the kidney’s blood vessels.1

The renin cells can trigger a buildup of another cell type, called smooth muscle cells, which cause the vessels to stiffen and thicken, making it harder for blood to flow through the kidney as it should.1

The investigators also found that the long-term use of drugs that inhibit the renin-angiotensin system, such as ACE inhibitors, have a similar affect.1

The long-term use of these drugs was associated with hardened kidney vessels in both humans and lab mice.1

“It would be important to conduct prospective, randomized controlled studies to determine the extent of functional and tissue damage in patients taking medications for blood pressure control,” Ariel Gomez, MD, of UVA’s department of pediatrics and child health research center, said in the statement.1 “It is imperative to find out what molecules these cells make so that we can counteract them to prevent the damage while the hypertension is treated with the current drugs available today.”1

Hypertension puts individuals at risk for heart disease and stroke, which are the leading causes of death in the United States.2

Nearly half (47%) of adults in the United States, or about 116 million, have hypertension, and hypertension was a contributing or primary cause of more than half a million deaths in 2019, according to the CDC.2

Uncontrolled hypertension is defined as diastolic BP greater than 80 mmHg or systolic BP greater than 130 mmHg.2

References

1. Long-term use of blood pressure drugs may cause kidney damage, study suggests. EurekAlert. News release. January 12, 2022. Accessed January 13, 2022. https://www.eurekalert.org/news-releases/939871

2. Facts about hypertension. CDC. Updated September 27, 2021. Accessed January 13, 2022. https://www.cdc.gov/bloodpressure/facts.htm