Angiotensin-converting enzyme

It is.

And it's also the primary target for some of the most widely prescribed blood pressure medications on Earth, like ACE inhibitors.

ACE inhibitors, these are the drugs that end in pril, right? Lisinopril, captopril, enalapril.

Exactly.

Millions of people take these every single morning.

Walk me through the microscopic journey of how they actually work on this one to four-week timeline.

Well, the story starts with an enzyme called the angiotensin-converting enzyme, or ACE.

Okay.

So it starts at the kidneys, where the kidneys, when stimulated, reles- release renin, and renin stimulates angiotensinogen at the liver, and then we, which makes angiotensin I.

And we have the ACE enzyme in the lungs, which converts angiotensin I to angiotensin II, which causes the va- the vascular s- system to, uh, causes vasoconstriction and causes and stimulates the, um, adrenals to release aldosterone, and then also the brain to release antidiuretic hormone.

I think I got all that right.

That's, that's what I remember.

Uh, there are other pathways in which, uh, androgens can stimulate high blood pressure.

I talk about the central nervous system stimulation that can come from an- an- androgens, and the tools that we have in our toolbox to block the renin-angiotensin-aldosterone system may not affect that.

You may need an ACE inhibitor, uh, to, to help, you know, if you have increased pulse and high blood pressure because of the increased pulse.

There are other things.

My question is, what would happen if you took enough potassium initially? Would you lower blood pressure? And then you wouldn't need the diuretic or the potassium prescription.

Now, just as a side note, they also have another hypertension drug called ACE inhibitors, which retain potassium.

ACE inhibitors are one of the most effective drugs at handling hypertension.

I wonder if it's really the retention of potassium.

If you go buy a potassium supplement, it'll come in 99 milligram tablets.

And of course, sunlight only brings it down a few points, but every little bit helps.

And I think the big question that people ask is, can hypertension be reversed? In some cases it can, but unfortunately a lot of people are not given the alternatives to medication.

Lisinopril is an ACE inhibitor.

So renin cleaves angiotensinogen to angiotensin 1.

ACE, angiotensin converting enzyme, converts that to angiotensin 2.

And angiotensin 2 does four very catastrophic things at the same time.

Let me go through them really quick.

This is all your first line drug.

The first line.

Look at ACE inhibitors.

Lisinopril blocks the conversion, right, of angiotensin 1 to angiotensin 2.