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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of single dose (50 mg) Captopril (C) used either alone or associated to diuretics (50 mg hydrochlorothiazide -HCTI) in the treatment of mild-moderate essential arterial hypertension was studied in a multicentric study. Eighty eight patients were chosen. After a minimum of 4 month follow-up period 53.4% responded (BDP less than 95 mm Hg) to single dose C (group 1:47 patients), 89.77% to 50 mg C in single dose together with 50 mg HTIT (group 2: 32 patients), 95.45% of two 50 mg doses of C and 50 mg HCIT (group 3: 5 patients), and 97.72% responded to 3 doses of C and 50 mg of HCTI (group 4: 2 patients). The decrease in blood pressure values was statistically significant (p, 000, Wilcoxon test) in groups 1 and 2, having a mean decrease in blood pressure (BP) of 14%. In group 1 (n = 42) the SBP which initially was 165.72 +/- 11.32, decreased to 148.28 +/- 11.5 and the DBP decreased from 101.55 +/- 5.68 to 87.28 +/- 6.59. In group 2 (n = 32) the SBP decreased from 173.50 +/- 14.08 to 152.44 +/- 20.8 and the DBP from 103.34 +/- 5.29 to 87.47 +/- 6.39. The response to monotherapy could not be statistically correlated either to early essential hypertension or to the patients age. Treatment was discontinued in three cases due to the secondary effects, cough, ageusia and nervousness, showing the remaining patients a good tolerance. No changes were observed in the analytical parameters. This study shows the usefulness and tolerance of single dose C as the initial treatment of mild to moderate essential hypertension.
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PMID:[Captopril in single doses in the treatment mild-moderated arterial hypertension]. 219 35

Eighteen patients with non-insulin dependent diabetes mellitus (NIDDM), hypertension and nephropathy were randomized to receive captopril or enalapril for 6 months. Two patients with serum creatinine of greater than 400 mumol/l had to be excluded from the study because of rapidly deteriorating renal function after starting treatment. Of the remaining patients, 7 received captopril and 9 received enalapril. Blood pressure control was achieved in about 50% of patients with either drug alone. Serum creatinine and creatinine clearance were unchanged in both groups but there was a greater tendency for the former to increase in patients with higher pretreatment values. Proteinuria was reduced at 1 month only in the enalapril group which also showed a significant elevation of serum potassium after treatment. Captopril and enalapril have only a modest antihypertensive action in patients with NIDDM and nephropathy. Their use in patients with renal insufficiency must be balanced against the risk of further aggravating the deterioration of renal function.
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PMID:Comparison of captopril and enalapril in the treatment of hypertension in patients with non-insulin dependent diabetes mellitus and nephropathy. 221 Sep 87

Captopril, an angiotensin II-converting enzyme inhibitor, ameliorates the renal mesangial lesions associated with subtotal nephrectomy, a process associated with increased mesangial macromolecular flux and injury. In the present study uninephrectomized rats with proteinuria and focal glomerular sclerosis had increased mesangial heat-aggregated human IgG (AHIgG) uptake. However, uninephrectomized rats treated daily with captopril, which failed to develop either glomerular lesions or proteinuria, also had significantly elevated mesangial AHIgG levels. Our results suggest that increased mesangial macromolecular flux may occur independent of altered glomerular permselectivity changes and proteinuria and appears to be related to glomerular hyperfiltration rather than glomerular hypertension. Further, glomerular mesangial sclerosis may not be the direct result of increased mesangial macromolecular flux.
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PMID:Mesangial macromolecular uptake in captopril-treated uninephrectomized rats. 221 17

A 22 year old woman presented with lupus nephritis, hypertension, and intractable nephrotic syndrome. Albumin and furosemide given intravenously was ineffective. Captopril administered in a daily dose of 62.5 mg was associated with a reduction in proteinuria from 28 g/24 hours to 11.5 g/24 hours over 10 weeks, resulting in a weight reduction of 16 kg. This was achieved with relative preservation of renal function. Captopril should be considered in the treatment of intractable proteinuria in patients with lupus nephritis, or when cytotoxic drugs are refused, because of its efficacy and relative safety. Captopril should, however, be used as an adjunct and not as a substitute for standard treatment.
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PMID:Antiproteinuric effect of captopril in a patient with lupus nephritis and intractable nephrotic syndrome. 224 Dec 92

Captopril (0.15-10 mg/kg) administration in the anesthetized dog causes immediate hypotension concomitant with an increase in tonus of the assay tissue (cat terminal ileum) superfused with circulating blood (Vane's cascade method). The increase in cat terminal ileum tonus was antagonized by a bradykinin receptor antagonist, L-349b. Treatment of the animals with indomethacin blocked or reversed the hypotensive effect of captopril without affecting the increase in tonus of the cat terminal ileum. Captopril potentiated the hypotension induced by bradykinin injected intra-arterially, and indomethacin reduced the hypotensive effect of intra-arterially injected bradykinin. Addition of captopril or enalapril to the superfusing blood maintained at 37 degrees C in an extracorporeal circuit caused a long-lasting increase in the tonus of the cat terminal ileum. The present results support the hypothesis that immediate hypotension induced by captopril involves a prostaglandin-dependent component possibly resulting from increased bradykinin levels generated in the vicinity of captopril action.
Hypertension 1990 Feb
PMID:Hypotensive effect of captopril. Role of bradykinin and prostaglandinlike substances. 240 62

Successful long-term treatment of hypertension must include consideration of individual patients' life-style interfaced with the potential for adverse drug events. In a postmarketing surveillance study, 30,515 patients received captopril monotherapy and were evaluated by 7792 physicians. Mean systolic and diastolic blood pressures were reduced 17 and 11 mm Hg, respectively. Mean diastolic blood pressure was reduced 10% for patients with mild hypertension; larger mean reductions were noted for patients with moderate (16.5%) and severe (21.5%) hypertension. Captopril therapy was equally effective in all races (white, Hispanic, and black patients), age groups, and in isolated instances of systolic hypertension. Only 4.9% of patients reporting an adverse event required discontinuation of therapy. Headache (1.8%) and dizziness (1.6%) were the most frequently reported adverse events. Quality-of-life measures improved.
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PMID:Efficacy, safety, and quality-of-life assessment of captopril antihypertensive therapy in clinical practice. 240 3

We conducted this study to examine the effects of exogenous and locally synthesized angiotensin II (Ang II) on cultured bovine glomerulosa cell functions (i.e., aldosterone secretion and cell proliferation measured by [3H] thymidine incorporation into the deoxyribonucleic acids (DNA) after the arresting cell growth). The effects of Ang II were found to depend on the culture conditions. After 72 hours of serum-free culture, the differentiated function of cultured cells such as Ang II-induced aldosterone secretion was suppressed, and DNA synthesis was stimulated by Ang II. After 24 hours of serum-free culture, the cells showed a good steroidogenic response and DNA synthesis was inhibited after Ang II was added in a concentration-dependent manner (10(-11) to 10(-7) M). Ang II was detected in 24 hours of culture grown in a serum-free medium by a specific Ang II radioimmunoassay. Ion-exchange high-performance liquid chromatography indicated that this immunoreactive (ir) Ang II was composed mainly of Ang II with small amounts of angiotensin III (Ang III). The concentration of irAng II in the cultured medium was significantly reduced by the addition of captopril, indicating de novo generation and secretion of Ang II. Captopril (10(-5) to 10(-3) M) reduced aldosterone secretion and reciprocally increased DNA synthesis. Ang II antagonist, [Sar1, Ile8] Ang II, increased DNA synthesis presumably by competitive blockade of locally synthesized Ang II. In summary, Ang II inhibited cell proliferation. In addition to exogenous (circulating) Ang II, Ang II was generated and secreted by the glomerulosa cells themselves, and this locally synthesized Ang II appeared to work as an autocrine factor to stimulate aldosterone secretion and to suppress cell proliferation.
Hypertension 1990 Feb
PMID:Exogenous and locally synthesized angiotensin II and glomerulosa cell functions. 240 97

Experiments were conducted to compare the relative importance of the local renin-angiotensin systems in the rabbit renal and femoral vascular beds and their functional role in hemodynamic regulation. Angiotensin I (Ang I) (0.15 microgram/kg i.v.) elevated mean arterial blood pressure by 18 +/- 1 mm Hg in the renal experimental group and 19 +/- 1 mm Hg in the femoral experimental group; it decreased renal blood flow by 35 +/- 3% but increased femoral blood flow by 31 +/- 8%. All these effects were blocked by intravenous administration of captopril (2 mg/kg bolus injection plus 1 mg/kg/hr). Captopril also lowered mean arterial pressure by 17 +/- 3 and 16 +/- 2 mm Hg in the renal and femoral experimental groups, respectively, and it increased renal blood flow by 32 +/- 10% but reduced femoral blood flow by 21 +/- 4%. As a result, renal vascular resistance was decreased by 36 +/- 5%, but femoral vascular resistance remained unchanged. After captopril, plasma angiotensin II (Ang II) levels were decreased and Ang I levels increased in the two groups. The renal venous-arterial difference of Ang I was increased by captopril, but the femoral venous-arterial difference of Ang I was not, suggesting greater generation of Ang I in the kidney. In a separate group of bilateral nephrectomized rabbits, plasma Ang II levels as well as mean arterial pressure, femoral blood flow, and femoral vascular resistance were not changed by intravenous administration of captopril.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1990 Feb
PMID:In vivo comparison of renal and femoral vascular sensitivity and local angiotensin generation. 240 98

The effects of 9 months of orally administered captopril (25-50 mg/kg body wt/day) on aortic atherosclerosis was examined in normotensive Watanabe heritable hyperlipidemic rabbits. Captopril caused a significant decrease in aortic atherosclerosis. Total aortic surface involvement by lesions was reduced from 48 +/- 3.6% in control Watanabe rabbits to 30 +/- 3.9% with captopril treatment (p less than 0.01). Most of the decrease could be accounted for by a marked reduction in atherosclerosis of descending thoracic aortas from 49 +/- 5.2% to 15 +/- 3.9% in control and captopril-related groups, respectively (p less than 0.001). Significant decrease in cholesterol content of descending thoracic aorta was also observed in captopril-treated rabbits. Microscopic examination of the arterial lesions in captopril-treated animals suggested a relative decrease in cellularity and increase in extracellular matrix as compared with untreated animals. These studies indicate that captopril has a potent antiatherosclerotic action in the Watanabe heritable hyperlipidemic rabbit.
Hypertension 1990 Mar
PMID:Antiatherogenic effect of captopril in the Watanabe heritable hyperlipidemic rabbit. 240 2

Captopril given for 5 days to normotensive subjects caused a significant fall in blood pressure. The fall in blood pressure was greater on a low sodium diet (19.6%) and less on a high sodium diet (11%) whereas on a normal sodium intake it was 16.5%. This fall in blood pressure was related to the initial level of angiotensin II and the fall in angiotensin II and was also associated with large falls in plasma aldosterone and, on the normal sodium intake, a loss of sodium that amounted to approximately 140 mmol/normal subject studied over the 5 days. Patients with essential hypertension who were studied on their normal diets had a similar fall in blood pressure for a given plasma renin activity. Angiotensin converting enzyme inhibitors are therefore used in hypertension not because they are specific for patients with high blood pressure but because they are effective in lowering blood pressure in both normotensive and hypertensive subjects and cause few side effects. They are also particularly effective when used in conjunction with sodium restriction, diuretics, or calcium entry antagonists but less effective when combined with a beta-blocker.
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PMID:Why use angiotensin converting enzyme inhibitors to lower blood pressure? 241 21


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