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Abstract

LIVER ENZYMES ELEVATION IN HYPERTENSIVE PATIENTS TREATED WITH ANGIOTENSIN CONVERTING ENZYME INHIBITOR DRUGS IN A RURAL GENERAL HOSPITAL IN THE KINGDOM OF SAUDI ARABIA

Lina Abdullah Suleiman*, Prof./Abdelwahab Hassan Mohamed, Dr. Abdulmasih Raief Farkouh

ABSTRACT

Background: Adverse drug reactions are reported as part of using drugs in treatment of diseases. In a disease which needs lifelong treatment the side effects add more problems. Treatment of hypertensive patients with angiotensin converting enzyme inhibitors (ACE inhibitors) can elevate liver enzymes in some patients. Objective: To evaluate the effect of ACE inhibitors on the liver enzymes (alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Methodology: This paper is a part from the study: Evaluation of the Management of Hypertension in a Rural General Hospital in the Kingdom of Saudi Arabia. The study was a prospective cross-sectional hospital-based study. An interview-guided direct questionnaire was used. In the study, the Saudi guideline for management of hypertension was followed to manage 382 hypertensive patients coming to the department of internal medicine in a rural general hospital, the Kingdom of Saudi Arabia, from February 2013 to December 2015. ALT and AST were tested in 197 patients treated with ACE inhibitors. Perindopril, captopril, lisinopril and enalapril were used. Result: ACE inhibitors were the most antihypertensive agents used in the treatment. ALT was found increased in 22 patients and AST was increased in other 22 patients. Elevation was more than three upper normal limit in six patients. No patient reported any symptom of hepatotoxicity. In all patients, the elevation of the enzymes did not need stopping ACE inhibitors. Conclusion: The study had revealed a mild to moderate elevation in ALT and AST caused by the ACE inhibitors that did not need to stop them.

Keywords: Hypertension. Angiotensin converting enzyme inhibitors. ACE inhibitors. Liver enzymes. ALT. AST.


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