Zinc balance and medications commonly used in the management of heart failure

Abstract

Heart failure (HF) is a prevalent syndrome resulting in a high mortality rate. HF may be associated with zinc deficiency through a reduction in dietary intake, decreased absorption due to gastrointestinal edema, impaired motility or intestinal zinc losses. Diseases concomitant with HF such as diabetes mellitus (DM) and hypertension may enhance zinc deficiency. Medications given for HF may affect zinc metabolism in different ways. It was shown that thiazides may cause zincuria and a decrease in tissue zinc concentration. There is conflicting evidence about furosemide, even though patients with chronic furosemide treatment showed low tissue zinc levels in autopsies. Treatment with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) resulted in zincuria and zinc deficiency, but this outcome was not consistent in all studies. Beta-blockers did not alter plasma zinc concentration. Matrix metalloproteinases (MMPs) and ACE are zinc-containing enzymes, which play a role in the process of remodeling in HF. It was shown that ACE inhibitors may inhibit the activity of different MMPs. The exact interrelationship between HF, zinc-containing enzymes, zinc deficiency and the clinical manifestation of HF has to be investigated.

Zinc and human health: an update

“…The knowledge of the structure-function relationship of the cognate metallopeptidases is invaluable in the design and synthesis of highly specific and potent therapeutic agents. Today medications used in congestive heart failure treatment that lead to zinc deficiency include angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and the diuretic furosemide (Golik et al 1993;Cohen and Golik 2006;Trasobares et al 2007). Other medications widely used for volume reduction and hypertension are the thiazide diuretics, which cause zincuria and decrease the tissue zinc concentration (Witte et al 2001).…”

Estimation of toxic elements in the samples of different cigarettes and their impact on human health of Irish hypertensive consumers

“…It was investigated that the accumulation of Cd in the human body may replace Zn in the arteries, which contributes to arteries becoming brittle and inflexible. Once the arteries become inflamed and brittle, the body may coat them with Ca and fatty plaques to prevent their rupture [40]. This plaque unfortunately reduces the interior diameter of the arteries, resulting in more pressure being required to force the blood through the smaller diameter arteries, which in turn raises blood pressure [41].…”

Evaluation of Essential Trace and Toxic Elements in Scalp Hair Samples of Smokers and Alcohol User Hypertensive Patients

“…The antagonistic effect of Cd and Zn was investigated for the fact that the accumulation of Cd in the human body may replace Zn in the arteries, which contributes to arteries becoming brittle and inflexible. Once the arteries become inflamed and brittle, the body may coat them with Ca and fatty plaques to prevent their rupture [55].…”

“…This plaque unfortunately reduces the interior diameter of the arteries, resulting in more pressure being required to force the blood through the smaller diameter arteries, which in turn raises blood pressure [55]. The concentrations of Cu and Fe were higher in the scalp hair samples of smokers and alcohol drinker-hypertensive patients as compare to referents of both genders (Table 6).…”