Angiotensin Converting Enzyme Inhibitors and Exercise

A major physiological process that the human body implements to control blood pressure is through the renin-angiotensin-aldosterone regulatory pathway. The kidneys, which are a major location for water retention regulation (and through changes in blood volume regulate blood pressure), notice decreases in blood pressure and release renin, an enzyme that alters the conformation of proteins, which converts angiotensinogen into angiotensin I. Next, angiotensin I is altered into the conformation of angiotensin II by the action of angiotensin converting enzyme. Angiotensin II then causes many physiological effects that in turn increase blood pressure. These include causing cardiac hypertrophy, vasoconstriction throughout the body, stimulation of the adrenal cortex to release aldosterone and stimulation of the pituitary to release anti-diuretic hormone, each of which cause the retention of sodium and water in the kidneys. In an attempt to help regulate the blood pressure of those with hypertension, drugs have been designed that focus on the angiotensin converting enzyme. By decreasing the action of this enzyme from converting angiotensin I into angiotensin II, the physiological response to increase blood pressure that angiotensin II ensues can be greatly decreased. Through a decrease in salt and fluid retention and systemic vasodilation, blood pressure can be effectively decreased.

By decreasing blood pressure, the question arises as to the effect that angiotensin converting enzyme inhibitors (ACE inhibitors) have on exercise performance, as well as any possible effects that may cause this class of drugs to increase exercise capacity. Preliminary study has shown that ACE inhibitors show a slight decrease in one’s blood pressure during...

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... it appears that angiotensin converting enzyme inhibitors at a dose crafted to an individual can potentially increase VO2 max and well as increase the amount of time that an individual can perform aerobic exercise. It can be concluded that further studies must be carried out to determine whether lower ACE activity can lead to physiological effects that improve the performance of athletes.

Works Cited

Cooke GA, Williams S, Marshall P, Al-Timman J, Shelbourne J. (2002) [cited 2011 Oct 22]. A mechanistic investigation of ACE inhibitor dose effects on aerobic exercise capacity in heart failure patients. EUR HEART J [Internet]; 23(17): 1360-1368.

Wang P, Fedoruk MN, Rupert JL. (2008) [cited 2011 Oct 22]. Keeping Pace with ACE: Are ACE Inhibitors and Angiotensin II Type 1 Receptor Antagonists Potential Doping Agents?. SPORTS MED [Internet]; 38(12):1065-1079.