HYPERTENSION AND ASPRIN MEDICATION LINKED WITH REDUCED ALS RISK

ALS or Lou Gehrig disease is a neurodegenerative disease that affects nerve cells in the brain and the spinal cord. This fatal neurological disease that attacks the nerve cells (neurons)responsible for controlling voluntary muscles (muscle action we are able to control, such as those in the arms, legs, and face). The progressive degeneration of the motor neurons in ALS eventually leads to their death. ALS is a progressive neurodegenerative disease and most patients die within three to five years after symptoms appear. The disease belongs to a group of disorders known as motor neuron diseases, which are characterized by the gradual degeneration and death of motor neurons.

Researchers have found that the use of a hypertension medication i.e. angiotensin-converting enzyme inhibitors is associated with a reduced risk in the development of amyotrophic lateral sclerosis. At present, ALS is treated with a drug called riluzole. Riluzole is an anti-glutamate medication that appears to block the release of glutamate from neurones. It can improve the quality of life of ALS patients, but it cannot cure the disease. Therefore, researchers continue to search for other forms of treatment that could be of benefit to people with this condition or reduce the risk of ALS development.

Researcher Feng-Cheng Lin, M.D., of the Kaohsiung Medical University Hospital, Taiwan, and fellow co-authors used the total population of Taiwanese citizens to study the association between the use of ACEIs and the risk of developing ALS. The study group included 729 patients diagnosed with ALS between January 2002 and December 2008. They were compared with 14,580 control group individuals. About 15 percent of patients with ALS reported ACEI use between two to five years before their ALS diagnosis, while about 18 percent of the control group without ALS reported ACEI use.

The authors don’t know exactly how ACE inhibitors might protect against ALS, though they have several theories. For example, they pointed out that ACE inhibitors have been linked to a protective effect in other diseases that damage nerve cells, such as Alzheimer’s and Parkinson’s disease. So, the possibility arises that ACE inhibitors are somehow shielding nerve cells from damage.

The researchers also compared the use of other types of blood pressure-lowering medications, steroids, aspirin and nonsteroidal anti-inflammatory drugs and ALS risk. They found that aspirin was the only other drug associated with a reduced risk of ALS, according to the study. However, the authors pointed out that previous studies failed to find a link between aspirin and ALS risk. So, as with the ACE inhibitor findings, the researchers suggested that aspirin’s potential role in ALS needs to be further studied.

Based on this research, one cannot conclude that ACE inhibitors affect the risk of ALS, said Dr. Zianka Fallil, a neurologist at North Shore-LIJ’s Cushing Neuroscience Institute in Manhasset, N.Y.

The researchers acknowledge that their database had certain limitations i.e. onset of first symptom was not available, along with vitamin E intake and other important predictors of ALS, such as cigarette smoking and alcohol consumption. These limitations mean that further research is necessary before full conclusions can be drawn. “This was an observational population-based study; hence, more animal and clinical studies are required to assess the possibility of using ACEIs for treating ALS,” conclude the authors.