Lisinopril (Prinivil) is often used to treat heart failure because it lowers blood volume. Which of the following best explains how lisinopril lowers blood volume?
1. It has an antagonistic effect on angiotensin-converting enzyme.
2. It lowers aldosterone secretion, a hormone that increases sodium reabsorption.
3. It causes hypernatremia and increased renal tubule permeability, resulting in a diuretic effect.
4. It causes a diuretic effect by lowering the amount of sodium lost in the urine.
Correct Answer: 2
Rationale: ACE inhibitors lower blood volume by lowering the secretion of aldosterone from the adrenal cortex. Aldosterone is a hormone that increases the reabsorption of sodium and water. ACE inhibitors have an antagonistic effect on angiotensin-converting enzyme, but this action lowers blood pressure by reducing peripheral vascular resistance, not by lowering blood volume. Increasing sodium in the blood will not lower blood volume.
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