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

Antihypertensive agents may modify the renal effects of angiotensin converting enzyme inhibition (ACEI). This potential interaction, which is important in the diagnosis of renovascular hypertension was studied in two rat models with and without diuretic treatment prior to ACEI. Acute intravenous administration of furosemide or hydrochlorothiazide in one-kidney, one-clamp animals (1K1C) did not change glomerular filtration rate (GFR) or effective renal plasma flow (ERPF). ACEI administration after furosemide and hydrochlorothiazide decreased GFR (p less than 0.001, p less than 0.01) but not ERPF. Chlorothiazide administered to 1K1C prior to ACEI, decreased GFR (p less than 0.02) but not ERPF captopril administration to 1K1C which received hydrochlorothiazide intraperitoneally for 7-10 days decreased GFR (p less than 0.007) and ERPF (p less than 0.02), while two-kidney, one-clamp animals (2K1C) decreased GFR only in the clamped kidney (p less than 0.005). ERPF in 2K1C increased only in the contralateral kidney (p less than 0.01). Without diuretic 1K1C animals decreased GFR and ERPF after ACEI (p less than 0.005, P less than 0.001). In the clamped kidney of 2K1C rats, GFR and ERPF decreased significantly (p less than 0.0005, p less than 0.004) and contralateral kidney ERPF increased (p less than 0.001), but GFR did not. The consequences of ACEI on GFR are similar with or without diuretic. These data suggest that diuretic therapy may not significantly interfere with ACEI evaluation of renovascular hypertension.
 ...
PMID:Renal functional response to captopril during diuretic therapy. 156 84

A comparative study was made of the effects of a new therapeutic agent consisting of 50 mg captopril and 25 mg hydrochlorothiazide (Capozide) with an already existing agent Moduretic (50 mg hydrochlorothiazide and 5 mg amiloride). In the Capozide group (32 patients), 20 achieved normal blood pressure, 8 responded but were not brought under control, and 3 were non-responders. In the Moduretic group (31 patients), 17 achieved normal blood pressure, 10 were partially controlled and 4 were non-responders. Moduretic appeared to be most effective in patients previously untreated or who had been taking only one drug, while Capozide controlled patients who had been taking 1 or 2 antihypertensive drugs which had been either ineffective or poorly tolerated. The long-acting effect of a single dose of Capozide was demonstrated by blood pressure measurements taken at least 10 hours later. Both drugs were generally well tolerated and no significant changes were observed in the laboratory measurements. The combination of an angiotensin converting enzyme inhibitor with a diuretic proved more effective than single agents in lowering raised blood pressure. We therefore conclude that Capozide is an effective alternative to traditional medication in the treatment of moderate hypertension.
 ...
PMID:Comparative study of the efficacy and tolerance of capozide and moduretic administered in a single daily dose for the treatment of chronic moderate arterial hypertension. 353 48

Only approximately 40% to 50% of hypertensive patients will achieve goal blood pressures of <140/ 90 mm Hg with monotherapy, regardless of the medication used. Fixed-dose combination therapy with two different classes of antihypertensive agents will achieve goal pressures in more than 70%. The sixth Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure has suggested that the use of combination therapy is appropriate as initial treatment. The advantages of combinations include: 1) greater blood pressure decrease and response rates than monotherapy; 2) fewer side effects with small doses of two drugs than with large doses of one agent; 3) improved adherence to treatment; and 4) possibly lower cost of therapy. Many different combinations of diuretics and beta-blockers, angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists, as well as ACE inhibitors and calcium antagonists are available. Two of these, Ziac and Capozide, have been approved as initial therapy. It is possible that the number of hypertensive individuals controlled at goal blood pressure levels will be increased if combination therapy is used as initial treatment.
 ...
PMID:The role of combination therapy in the treatment of hypertension. 965 66