Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial

Nutrients. 2018 Sep 11;10(9):1284. doi: 10.3390/nu10091284.


Background: Antihypertensive drugs affect mineral metabolism, inflammation, and the oxidative state. The aim of this study was to evaluate the effects of antihypertensive monopharmacotherapy with diuretics, β-blockers, calcium antagonists (Ca-antagonists), angiotensin-converting enzyme inhibitors (ACE-I), and angiotensin II receptor antagonists (ARBs) on zinc (Zn), iron (Fe), and copper (Cu) status, parameters of oxidative and inflammatory states, and glucose and lipid metabolism in patients with newly diagnosed primary arterial hypertension (AH).

Methods: Ninety-eight hypertensive subjects received diuretics, β-blockers, Ca-antagonists, ACE-I, or ARB for three months. Zn, Fe, and Cu concentrations were determined in blood, urine, and hair.

Results: A decrease in zinc serum and erythrocyte concentration and an increase in zinc urine concentration were registered after diuretic administration. Ca-antagonists led to a decrease in erythrocyte zinc concentration. A decrease in serum zinc concentration was observed after ACE-I. A decrease in triglyceride serum concentration was noted after ACE-I therapy, and a decrease in tumor necrosis factor-α serum concentration was seen following administration of Ca-antagonists. Hypotensive drugs led to decreases in catalase and superoxide dismutase serum concentrations.

Conclusions: Three-months of monotherapy with diuretics, Ca-antagonists, or ACE-I impairs zinc status in patients with newly diagnosed primary AH. Antihypertensive monopharmacotherapy and zinc metabolism alterations affect lipid metabolism, the oxidative state, and the inflammatory state.

Keywords: antihypertensive pharmacotherapy; mineral metabolism; zinc.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Biomarkers / metabolism
  • Blood Pressure / drug effects*
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use*
  • Diuretics / adverse effects
  • Diuretics / therapeutic use*
  • Female
  • Hair / metabolism
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / metabolism
  • Hypertension / physiopathology
  • Inflammation Mediators / metabolism
  • Lipid Metabolism / drug effects
  • Male
  • Middle Aged
  • Nutritional Status / drug effects*
  • Oxidation-Reduction
  • Poland
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Zinc / metabolism*


  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Biomarkers
  • Calcium Channel Blockers
  • Diuretics
  • Inflammation Mediators
  • Zinc