Introduction:
A natural treatment added to Ace inhibitor ramipril improved blood pressure, kidney function, proteinuria, and blood glucose over ramipril alone.
Ace inhibitor plus ramipril:
This combination improved blood pressure, kidney function, proteinuria, and blood glucose over ramipril alone in 2 similar studies. Pycnogenol, French maritime pine bark extract, may be helpful to those suffering from metabolic syndrome. Study participants (n=58) were split into two groups. Both groups were being treated with ramipril (5mg twice daily), an anti-hypertensive medication, and were instructed to follow a healthier lifestyle. One group was given Pycnogenol (50 mg 3 times/day) in addition to ramipril. Results show that Pycnogenol plus ramipril significantly further lowered blood pressure (BP) when compared to the group taking ramipril alone. After 6 months of treatment, average BP in the ramipril group was lowered to an almost high value of 128.2/90.2 mmHg, while the value in the group taking Pycnogenol with ramipril reached near normal levels (122.2/85.3 mmHg). Kidney function improved in both groups. With ramipril alone, urinary protein decreased by 22% but with the addition of Pycnogenol it decreased by 52.7%. The group taking Pycnogenol also had a lowered fasting blood glucose level, which was reduced from high values to healthy values after 6 months of treatment. Only the group taking Pycnogenol was found to significantly lost weight after 6 months from average BMI 26.5 to 25.0. (1)
Researchers reported the benefits of adding Pycnogenol, French maritime pine bark extract, to a standard medical treatment of hypertensive (high blood pressure) patients with deteriorating kidney function. The participants (n=55) were randomly assigned to receive either Pycnogenol plus the blood pressure-lowering drug ramipril (ACE inhibitor) or ramipril (10 mg) alone for 6 months. Urinary albumin was used as a measure of kidney function – albumin is the most abundant protein in people with kidney problems which leaks from the kidney into the urine. The authors found that albumin levels in the urine decreased significantly in the Pycnogenol group (-52 mg/day) compared to ramipril alone (-23 mg/day only). Pycnogenol also improved systolic and diastolic flow by 12% and 8%, respectively. (2)
Assessment and Plan: Ace Inhibitor and Pycnogenol
- Pycnogenol plus ramipril significantly further lowered blood pressure (BP), improved kidney function, improved proteinuria, and reduced fasting blood glucose when compared to the group taking ramipril alone.
References:
1.Stuard S, Belcaro G, Cesarone MR, et al. Kidney function in metabolic syndrome may be improved with Pycnogenol®. Panminerva Med. 2010 Jun;52(2 Suppl 1):27-32. http://www.ncbi.nlm.nih.gov/pubmed/20657531
2.Cesarone MR, Belcaro G, et al. Kidney Flow and Function in Hypertension: Protective Effects of Pycnogenol in Hypertensive Participants—A Controlled Study. J Cardiovasc Pharmacol Ther. 2010 Mar;15(1):41-6. http://www.ncbi.nlm.nih.gov/pubmed/20097689