Blood Pressure Medications May Lower Risk of ALS

ACE inhibitors may decrease risk of developing ALS, new study found

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) ACE inhibitors are often used to treat high blood pressure and heart failure. But new research suggests they may also prevent ALS.

A new study from Taiwan found that ACE inhibitors may decrease the risk of amyotrophic lateral sclerosis, also called ALS or Lou Gehrig's disease.

Patients who took ACE inhibitors were much less likely to develop ALS than people who didn't take the medications. And patients who took the medications longer appeared to have a lower risk of ALS.

Feng-Cheng Lin, MD, of the Kaohsiung Medical University Hospital in Taiwan, led the study. Dr. Lin and team studied 729 patients — 278 women and 451 men — who had been diagnosed with ALS between January 2002 and December 2008.

The researchers compared these patients to 14,580 patients in a control group — which means these patients did not have ALS. The study authors found that patients who had taken blood pressure medications called ACE inhibitors were less likely to develop ALS.

Past research has found that ACE inhibitors may slow cognitive decline in patients with similar diseases like Parkinson’s or Alzheimer’s disease.

ACE inhibitors relax blood vessels which leads to a reduced blood pressure. They may also decrease free radicals. Free radicals are molecules that can damage cells, including nerve cells. Patients with ALS were more likely to have high numbers of free radicals, the study authors wrote.

Dr. Lin and colleagues used a measure called the defined daily dose (DDD) to compare different ACE inhibitors. The DDD is the amount of a medication an adult who weighs around 154 pounds takes in one day. The actual dose of each medication would vary. For instance, 50 milligrams of captopril (Capoten) and 10 milligrams of enalapril (Vasotec) — two types of ACE inhibitors — each equal one DDD.

The study authors found that patients who had taken daily doses of an ACE inhibitor for more than 449.5 days were 57 percent less likely to develop ALS than people who had not taken ACE inhibitors.

The study included all patients in Taiwan who were seen in general medical practices between 2002 and 2008. Taiwan has a single-payer, government-funded insurance system that collects data on all of its population.

ALS is a progressive nervous system disease. Over time, patients lose control of their voluntary muscle functions. Patients can eventually become paralyzed. There is no cure.

By age 70, between 1 in 400 and 1 in 1,000 people will develop ALS, according to Dr. Lin and colleagues. The ALS Association reports that around 5,600 people in the US are diagnosed with ALS each year.

Most patients with ALS die within three to five years of the diagnosis. Past research indicated that ACE inhibitors might protect the nerve cells that ALS destroys.

“To our knowledge, the present study is the first to screen the association between [ACE inhibitors] and ALS risk in a population-based study,” Dr. Lin and colleagues noted.

The authors said the study's large sample size was a major strength of the findings. They noted, however, that the study did not include several important factors, such as patients’ use of vitamin E. Past research has tied vitamin E to a decreased risk of ALS. The researchers also did not include smoking or alcohol use in the study.

This study was published Nov. 10 in JAMA Neurology.

The Ching-Ling Foundation of Taipei Veterans General Hospital funded the study. The authors did not disclose any conflicts of interest.

Review Date: 
November 10, 2014
Last Updated:
November 13, 2014