Zestoretic combines two medicines that have different ways of working and which doctors know leads to a greater lowering of blood pressure and usefulness in some people than with either medicine used alone.

• Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor which blocks the production of a hormone (chemical signal carried in the blood) called angiotensin II.
  
  
  • Angiotensin II is a chemical that is made by the body, which narrows blood vessels and thereby maintains (elevates) blood pressure.
    
    
  • ACE is an enzyme (a chemical that controls other chemical reactions) in the body that is important for the formation of angiotensin II.
    
    
  • When ACE is blocked by lisinopril, angiotensin cannot be converted into its active form, angiotensin II.
    
    
  • Blood pressure falls due to relaxation and widening of the arteries.
    
    
• Hydrochlorothiazide is a diuretic (water pill):
  
  
  • It works by stopping the re-absorption of salts and water from the kidneys back into the bloodstream.
    
    
  • This results in increased urine output (diuresis) and loss of salt in the urine, which help to lower blood pressure.

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