ACE Inhibitors
Common brand names: Lisinopril, Enalapril, Ramipril
One nutrient listed against this medication. The most severe is marked moderate.
At a glance
At a glance
- ZincModerate · Moderate evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Captopril (a sulfhydryl-containing ACE inhibitor) increased urinary zinc excretion, and both captopril and enalapril lowered mononuclear-cell zinc, in a small controlled human study. The effect may not be uniform across all ACE inhibitors.
Common signs, Zinc supports immune function, taste and smell, and wound healing; altered taste is a recognized captopril effect.
Golik et al., J Am Coll Nutr 1998 (PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 9477394): small controlled study (captopril, enalapril, and control groups) finding increased urinary zinc with captopril and reduced mononuclear-cell zinc with both drugs. No clinical deficiency outcome or number-needed-to-harm was reported.
If dietary zinc is low or compatible symptoms are present, testing and repletion are a discussion for the clinician rather than something to start automatically. No dose is given here, because the cited paper studied zinc status on an ACE inhibitor and tested none. The copper caution at intakes above roughly 40 mg/day is the established upper-intake concern and is not from a trial cited on this row.
The benefit, in absolute numbers
Each chart turns one trial result into people, using the two percentages the number needed to treat (NNT Number needed to treat: how many people must receive a treatment for one of them to benefit, compared with the control group.) is calculated from. The counts are rounded to whole people; nothing else is estimated. These figures describe the trial population, not any one person.
Out of 1,000 people like those studied, about 268 had this outcome without the drug and 230 with it. The difference, 38 people, is the benefit. 732 did not have it in either group.
Blood Pressure Lowering Treatment Trialists' Collaboration, Lancet 2014 (PMID 25131978) · Individual-patient-data meta-analysis A study that pools the numbers from several trials into one combined estimate., risk-stratified · Highest baseline cardiovascular-risk stratum, mean estimated 5-year risk 26.8% (individual-patient-data meta-analysis covering all blood-pressure-lowering drug classes, not ACE inhibitors alone; 38 events prevented per 1,000 treated for 5 years)
For your next appointment
It prints or saves as a single page. Whether to add a supplement for a nutrient this medication may lower is a decision for your prescriber.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →