Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.15.1 (ACE)
 18,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Presentation of drugs most worthy of interest in autumn 1995. Among these, the ACE inhibitors, the HMGCOA inhibitors, the Proton Pump inhibitors, the serotoninergics used against depression and migraine, the endobronchial corticoids and finally the ASA. Review of their successes, failures and uncertainties.
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PMID:[Leading drugs in 1995: success, failures and uncertainties]. 748 Dec 49

The Hypertension Optimal Treatment (HOT) Study is a prospective, randomized, multicenter trial being conducted in 26 countries. Its main aim is to evaluate the relationship between three levels of target diastolic blood pressure (< or = 90, < or = 85 or < or = 80 mmHg) and cardiovascular morbidity and mortality in hypertensive patients. In addition, the study will examine the effects on morbidity and mortality of a low dose, 75 mg daily, of acetylsalicylic acid (ASA, aspirin) or placebo. In the HOT Study, basic antihypertensive treatment is initiated with the calcium antagonist felodipine at a dose of 5 mg daily. If target blood pressure is not reached, additional antihypertensive therapy with either an angiotensin converting enzyme (ACE) inhibitor or a beta-adrenoceptor blocking agent is given. Further dosage adjustments are made in accordance with a set protocol. As a fifth and final step, a diuretic may be added. Inclusion of patients was stopped on April 30, 1994. At that time 19,196 patients had been randomized. There were 9,055 (47%) women and 10,141 (53%) men with an average age of 61.5 +/- 7.5 (SD) years. At enrollment, 52% of patients were receiving antihypertensive treatment. These patients entered a wash-out period of at least 2 weeks before randomization. The average randomization blood pressure in untreated patients was 169 +/- 14/106 +/- 3 mmHg and in the treated patients 170 +/- 14/105 +/- 3 mmHg. On August 15, 1994, blood pressure data were available for 14,710 and 10,275 patients, who had completed 3 and 6 months treatment, respectively. The average reduction in diastolic blood pressure was 22 mmHg after 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The Hypertension Optimal Treatment (HOT) Study--patient characteristics: randomization, risk profiles, and early blood pressure results. 786 89

The Hypertension Optimal Treatment (HOT) Study is a prospective, randomized, multicenter study which will be conducted in some 20 countries world-wide. Two major issues will be investigated: i) What is the optimal target diastolic blood pressure during antihypertensive treatment with regard to the reduction in cardiovascular morbidity and mortality? In order to address this question patients will be randomized to three different therapeutic goals: a diastolic blood pressure < or = 90 mmHg, < or = 85 mmHg or < or = 80 mmHg; ii) The second aim is to evaluate the effect of a low dose acetylsalicylic acid (ASA, aspirin) 75 mg o.d. in comparison with placebo on cardiovascular morbidity and mortality. The first aim will be investigated in accordance with the PROBE design (Prospective Randomized Open Blinded Endpoint evaluation), whereas the evaluation of aspirin versus placebo will be conducted under double blind conditions. It is estimated that 1,100 clinical events will be needed in order to answer the question regarding the relationship between target diastolic blood pressure and major cardiovascular events. The collection of these events will require the enrollment of at least 18,000 hypertensive men and women aged 50-80 years to be followed for 2.5 years (about 40,000 patient years). All patients will be given felodipine 5 mg o.d. as basic antihypertensive treatment with the addition of a beta-blocker or an ACE-inhibitor in a second step, with further predetermined increments in dosage as required in order to obtain the randomized therapeutic goal.
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PMID:The Hypertension Optimal Treatment Study (the HOT Study). 819 35

The relationship between serum angiotensin-converting enzyme activity (SACE) and inflammatory bowel disease was investigated in 30 patients with active Crohn's disease (CD) (CDAI > 150), 12 patients were not taking active medication, while 11 were on prednisone and 7 on mesalazine (5-ASA). Of 12 patients with active ulcerative colitis (UC), 4 patients were without treatment, 4 were on prednisone and 4 on mesalazine. Twelve patients with acute pulmonary sarcoidosis and 25 healthy subjects were studied. SACE levels in CD were not significantly different compared to healthy subjects and did not appear to be affected by the anti-inflammatory therapy. The average levels of SACE in UC were significantly higher than those of healthy subjects and CD (p < 0.005). Among the UC patients there was a trend for lower levels in the group treated with prednisone. In patients with active sarcoidosis SACE levels were extremely elevated and were significantly higher than in all other groups examined (p < 0.0001). The granulomatous inflammation in Crohn's disease differs from that of sarcoidosis, in which there is a striking elevation of angiotensin converting enzyme in serum. In other words, SACE levels seem to differentiate patients with active CD from patients with UC.
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PMID:Serum angiotensin converting enzyme activity in Crohn's disease and ulcerative colitis. 838 13

The susceptibility to ventricular arrhythmias under the conditions of cardiac ischemia and reperfusion was investigated in the Langendorff heart preparation of rats fed for eight weeks a standard chow enriched with 2% of pulverized wild garlic leaves. The isolated hearts were perfused with a modified Krebs-Henseleit solution. The incidence of ventricular fibrillation (VF) during 20 min occlusion of the descending branch of the left coronary artery (LAD) was significantly reduced in the wild garlic group as compared to untreated controls (20% vs 88%). The same holds for the size of the ischemic zone (33.6% vs 40.9% of heart weight). In the reperfusion experiments (5 min after 10 min ischemia), ventricular tachycardia (VT) occurred in 70% of the wild garlic group vs 100% in untreated controls and VF in 50% vs 90%. The time until occurrence of extrasystoles, VT or VR was prolonged. No significant alterations in cardiac fatty acid composition could be observed. Although the prostacyclin production was slightly increased in hearts of the wild garlic group, inhibition of cyclooxygenase by acetylsalicylic acid (ASA; aspirin) could not completely prevent the cardioprotective effects suggesting that the prostaglandin system does not play a decisive role in the cardioprotective action of wild garlic. Furthermore, a moderate angiotensin converting enzyme (ACE) inhibiting action of wild garlic was found in vitro as well as in vivo that could contribute to the cardioprotective and blood pressure lowering action of wild garlic. Whether a free radical scavenging activity of wild garlic is involved in its cardioprotective effects remains to be established.
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PMID:Cardioprotective actions of wild garlic (allium ursinum) in ischemia and reperfusion. 845 76

The Hypertension Optimal Treatment (HOT) Study is an ongoing prospective, randomized, multicenter trial conducted in 26 countries. Its two main aims are to evaluate the relationship between three levels of target diastolic blood pressure (< or = 90, < or = 85 or < or = 80 mmHg) and the incidence of cardiovascular morbidity and mortality in hypertensive patients and the effects on morbidity and mortality of a low dose, 75 mg daily, of acetylsalicylic acid (ASA, aspirin) compared with placebo. Altogether 19,193 patients have been recruited and randomized and one-year data are now available for all patients. This is a report on the blood pressures achieved, the tolerability and other available data after 12 months of follow-up of all patients. Special reference will be given to the subgroup of elderly patients (> or = 65 years, n = 6,113) as compared to younger patients (< 65 years, n = 13,080). On average, the target group < or = 90 mmHg in diastolic blood pressure has reached 86 mmHg, the target group < or = 85 mmHg has reached 83 mmHg and the target group < or = 80 mmHg has reached 81 mmHg. The percentage of patients that has obtained their target blood pressures is 84% in the target group < or = 90 mmHg, 72% in the target group < or = 85 mmHg and 57% in the target group < or = 80 mmHg at 12 months of follow-up. In the elderly subgroup (> or = 65 years of age) the percentage of patients at target is higher for all target groups, being 86, 76 and 61%, respectively, at 12 months. Antihypertensive treatment is initiated with a calcium antagonist, felodipine, at a dose of 5 mg once daily. If target blood pressure is not reached, additional antihypertensive therapy, with either an angiotensin converting enzyme (ACE) inhibitor or a beta-adrenoceptor blocking agent, is given. Further dose adjustments are made in accordance with a set protocol. As a fifth and final step a diuretic may be added. Side effects have been relatively few in this large multinational series of intensively treated hypertensive patients. Only ankle edema, 2.6% and 3.0%, and coughing, 1.3% and 0.8%, in young and elderly patients, respectively, exceed a frequency of 1%, and 88% of all patients are still taking their baseline therapy felodipine after one year. The one-year data presented here indicate that it should be possible to fulfill the primary aims of the HOT Study.
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PMID:The Hypertension Optimal Treatment (HOT) Study: 12-month data on blood pressure and tolerability. With special reference to age and gender. 853 54

1. Angiotensin converting enzyme inhibitors have been suggested to act in part by potentiating the stimulatory effect of bradykinin on endothelial prostacyclin and/or nitric oxide (NO) formation. This may give rise to interaction with cyclo-oxygenase inhibiting drugs like acetylsalicylic acid, which is most often used in low doses in patients with cardiovascular diseases. 2. We investigated the effects of captopril (2 x 25 mg day-1), or ASA (1 x 100 mg day-1), or the combination of both drugs for 7 days, on blood pressure, prostanoid and NO formation rates in a double-blind, double dummy, randomized crossover study in 13 healthy female subjects. The urinary metabolites of thromboxane A2 (2,3-dinor-TXB2) and prostacyclin (2,3-dinor-6-keto-PGF1 alpha), and PGE2 were measured by gas chromatography/tandem mass spectrometry in urine on days 1, 6 and 7 of each medication. NO formation was assessed using urinary NO3- and cyclic GMP as indicators. 3. Urinary 2,3-dinor-6-keto-PGF1 alpha excretion was not significantly changed by either captopril, ASA, or their combination. Urinary 2,3-dinor-TXB2 excretion was inhibited by > 80% by ASA alone or in combination with captopril (each P < 0.05), but was not affected by captopril alone. Urinary PGE2 excretion was not significantly changed by either of the treatments. Urinary NO3- and cyclic GMP excretion rates were not significantly changed by captopril, ASA, or their combination. 4. Blood pressure was slightly reduced by captopril. ASA had no effect on blood pressure when given alone, nor did it modulate the effect of captopril on blood pressure during co-administration. Angiotensin II/angiotensin I ratio (index of ACE activity) was significantly decreased by captopril alone or in combination with ASA, but was unaffected by ASA alone. 5. Captopril does not stimulate prostacyclin formation in healthy human subjects in a dose sufficient to substantially inhibit ACE activity. Co-administration of ASA significantly inhibits 2,3-dinor-TXB2 excretion, but does not interfere with the blood pressure lowering effect of captopril in healthy human subjects.
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PMID:Effect of captopril on prostacyclin and nitric oxide formation in healthy human subjects: interaction with low dose acetylsalicylic acid. 897 27

The Hypertension Optimal Treatment (HOT) Study is an ongoing prospective randomized, multicentre trial conducted in 26 countries. There are two main aims of the study. The first is to evaluate the relationship between three levels of target diastolic blood pressure (< or = 90, < or = 85 or < or = 80 mmHg) and the incidence of cardiovascular morbidity and mortality in hypertensive patients. The second is to determine the effect on morbidity and mortality of a low dose, 75 mg daily, of acetylsalicylic acid (ASA, aspirin) compared with placebo. Altogether 18,790 patients have been recruited and randomized, and two-year data are now available for all patients. This is a report on the blood pressures achieved, the tolerability, and other available data after 24 months of follow-up of all patients. Special emphasis is given to the subgroup of elderly patients (> or = 65 years, n = 5988) compared with young patients (< 65 years, n = 12 802). On average, patients in the < or = 90 mmHg diastolic blood pressure target group have reached 85 mmHg, in the < or = 85 mmHg target group patients have reached 83 mmHg and in the < or = 80 mmHg target group patients have reached 81 mmHg. The percentage of those achieving target blood pressure in each target group at 24 months of follow-up is 85% in the < or = 90 mmHg target group, 75% in the < or = 85 mmHg target group and 57% in the < or = 80 mmHg target group. In the elderly subgroup (> or = 65 years of age), the percentage of patients achieving target at 24 months is higher for all target groups, namely 89% in the < or = 90 mmHg group, 80% in the 85 mmHg group and 62% in the 80 mmHg group. Antihypertensive treatment was initiated with a calcium antagonist, felodipine, at a dose of 5 mg once daily. If target blood pressure was not reached, additional antihypertensive therapy, with either an angiotensin converting enzyme (ACE) inhibitor or a beta-adrenoceptor blocking agent, was given. Further dose adjustments were made in accordance with a set protocol. As a fifth, and final, step, a diuretic could be added. There have been relatively few side effects in this large, multinational study of hypertensive patients. Only ankle oedema and coughing exceed a frequency of 0.5% (ankle oedema 1.3% in young and 1.7% in elderly; coughing 0.5% in young and elderly). After two years, 84% of all patients are still taking their baseline therapy, felodipine. The 24-month data presented here indicate that it should be possible to fulfil the primary aims of the HOT Study.
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PMID:The Hypertension Optimal Treatment (HOT) Study: 24-month data on blood pressure and tolerability. 936 3

The use of hypolipidemic drugs has been analyzed in 1,113 patients after myocardial infarction using a questionnaire with data entered from the medical records by spa physicians. 80.1% of patients had total cholesterol values > 5.2 mmol/l; mean value being 6.16 +/- 1.08 mmol/l. Mean values of LDL-cholesterol were 4.05 +/- 0.1 mmol/l, of triglycerides 2.01 +/- 1.14 and of HDL-cholesterol 1.26 +/- 0.61 mmol/l. Hypolipidemic drugs were used only in 16.5% patients with total cholesterol values above 7.0 mmol/l, in 14.4% patients with total cholesterol values 6.2-7.0 mmol/l and in 11.4% of patients with cholesterol values 5.2-6.2 mmol/l. Even some patients with cholesterol more than 8.0 mmol/l were not treated by hypolipidemic drugs. The most frequently used drugs were fibrates (phenofibrate, gemfibrozil)--in 89.5% patients. Statins were used only in 7.5% patients receiving hypolipidemic drugs. Our results show that in contrast to the US and European Recommendations for hypolipidemic drug therapy in patients with CHD, this treatment is still infrequently used by Czech cardiologists and internists. This discrepancy is even more apparent when comparing it with other life prognosis improving drug therapies in this group of patients. Antiplatelet drugs, mainly ASA were used in 85.5% patients, beta-blocking drugs in 59.3% patients and ACE inhibitors in 55.9% patients with left ventricular systolic dysfunction. Thus hypolipidemic therapy in CHD is the key problem of drug therapy in patients after myocardial infarction in the Czech Republic.
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PMID:[Use of drug therapy in hyperlipidemia in patients after myocardial infarct in the Czech Republic]. 960 32

Sarcoidosis presenting solely as a granulomatous colitis is rare and appears identical to Crohn's disease. A 56-yr-old woman developed a Crohn's-like illness, which remitted after 5-ASA therapy. Two months later, she developed fever, adenopathy, muscle weakness, and peripheral neuropathy. A diagnosis of sarcoidosis was made after an extensive search for an infectious or rheumatological cause. This case illustrates the utility of serum angiotensin converting enzyme level in differentiating sarcoidosis from Crohn's disease.
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PMID:Sarcoidosis presenting as granulomatous colitis. 977 62


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