ALS Risk Lowered Through Use of ACE-inhibitors, According To Study

A new study entitled “Angiotensin-Converting Enzyme Inhibitors and Amyotrophic Lateral Sclerosis Risk A Total Population–Based Case-Control Study” reports that using angiotensin-converting enzyme inhibitors (ACEIs) significantly decreases the risk for developing amyotrophic lateral sclerosis. The study was published in the journal Jama Neurology.

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease characterized by damaging of nerve cells both in the brain and spinal cord. Specifically, the disease affects motor neuron cells, leading to a loss of the ability to control voluntary muscles, including those responsible for walking, speaking, swallowing and breathing. The disease ultimately culminates in patients’ death.

Previous reports suggested that using angiotensin-converting enzyme inhibitors (ACEIs) decreased the risk to develop ALS, however, the majority of these studies were performed using animal models. ACEIs are a group of pharmaceutical drugs primarily developed for treating hypertension and heart failure, by inducing blood vessels’ relaxation and decreasing the blood volume that is pumped through it,in lower blood pressure. In this study, the authors investigated whether this association was maintained in human subjects.

To that end, a team of researchers at the Kaohsiung Medical University Hospital, Taiwan investigated this association in the total population of Taiwanese citizens who were inpatients in general hospitals. The group of patients analyzed included 729 patients newly diagnosed with ALS, and compared their results with a control group of 14,580 individuals, matching the subject ALS group in sex, age, residence, and insurance. They then measured the cumulative defined daily dose (cDDD) and correlated it with the risk to develop ALS. ACEIs were taken by 15% of the patients in the ALS group and 18% of the individuals in the control group.

The authors found that patients who were using ACEIs exhibited a 17% reduction in the risk of developing ALS (for patients with a cDDD lower than 449.5), and a 57% reduction in patients with a cDDD of more than 449.5, when compared to the group of patients who did not take ACEIs. Notably, they observed that the inverse dose-dependent association was more pronounced in male patients with more than 55 years old.

The authors highlight that while previous studies suggest the potential neuroprotective role of ACEIs in neurodegenerative diseases, such as Alzheimer and Parkinson’s disease, their study is the first demonstrating their therapeutic potential in a generalized population.