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

This double-blind study was conducted to investigate the efficacy, safety and tolerability of three dose levels of moexipril in comparison to placebo as add-on therapy to hydrochlorothiazide (HCTZ) in patients with moderate to severe hypertension. Two hundred patients who did not respond adequately to a 4-week monotherapy with HCTZ-sitting diastolic blood pressure between 95 and 114 mm Hg- entered the 8-week double-blind period. Patients were randomized to once daily placebo or moexipril 3.75, 7.5 or 15 mg as add-on therapy to open-label HCTZ 25 mg. At biweekly visits, blood pressure and heart rate measurements were obtained and the occurrence of adverse experiences was documented. At the 8-week endpoint, adjusted mean reductions from baseline were significantly (p = 0.003) greater in patients receiving moexipril 3.75, 7.5 and 15 mg compared to placebo (-8.4, -8.8 and -8.9 vs. -4.6 mm Hg). No significant differences between the three dose levels of moexipril could be observed. Moexipril was generally well tolerated. The most frequently reported adverse events for moexipril and placebo were headache, flu syndrome and dizziness (6, 7, 5 vs. 4, 0, 4%). The results indicate that the combination of moexipril and HCTZ is a clinically valuable combination in the treatment of patients with moderate to severe hypertension.
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PMID:Moexipril as add-on therapy to hydrochlorothiazide in moderate to severe hypertension. 879 66

Moexipril is a new, long-acting angiotensin-converting enzyme (ACE) inhibitor. In contrast to captopril, it is a prodrug of the pharmacologically active agent moexiprilat and will be administered once daily. The objective of this study was to compare the efficacy, safety, and tolerability of moexipril with that of captopril during a 12-week treatment of patients with mild to moderate hypertension. Patients with a sitting diastolic blood pressure (SDBP) of 95-114 mm Hg, inclusive, were randomized in a 2:1 ratio to receive moexipril, 7.5 mg, once daily or captopril, 25 mg, twice daily. After 6 weeks of treatment, the dose of moexipril and captopril was increased to 15 mg once daily and 50 mg twice daily, respectively, if the patient's SDBP remained > or = 90 mm Hg. Blood pressure was measured at biweekly visits. At study endpoint, adjusted mean reductions in SDBP were comparable between the moexipril and captopril groups (-9.8 vs. -8.7 mm Hg), and moexipril was more effective than captopril in reducing sitting systolic blood pressure. Adverse experiences (headache, dizziness, and upper respiratory infection) occurred at similar frequencies in the moexipril and in the captopril groups. The data indicate that moexipril at dosages of 7.5 and 15 mg once daily is as efficacious as twice daily captopril in reducing blood pressure in patients with mild to moderate hypertension.
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PMID:Moexipril versus captopril in patients with mild to moderate hypertension. 896 Oct 74

24-hour monitoring of arterial pressure was performed before, 3 and 9 weeks after moexipril treatment (daily dose 7.5-15 mg) for mild and moderate hypertension. Of 15 patients treated 66.6% responded to the 9-week course. Adjuvant hypothiazid elevated the effect to 73.6%. Moexipril lowered mean 24-h diastolic pressure without changing the 24-h pressure curve or heart rate. Antihypertensive moexipril effect was higher in the day time. Variability of diastolic arterial pressure was lower at night.
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PMID:[The effect of the new angiotensin-converting enzyme inhibitor moexipril on the circadian rhythms of arterial pressure in hypertension patients]. 922 35

ACE inhibitors induce metabolic changes and exert cardioprotective and vasoprotective properties, some of which cannot be attributed to their antihypertensive effect per se. Moexipril is an ACE inhibitor with a lipophilicity in the same range as quinapril, benazepril or ramipril, and so can readily penetrate lipid membranes and thus target tissue ACE in addition to plasma ACE. Evidence from animal studies shows similar and significant (p < 0.05) reductions in tissue ACE activity for moexipril and quinapril. Moexipril may improve endothelial dysfunction; moexiprilat and ramiprilat have demonstrated greater activity than captopril, enalaprilat and quinaprilat in isolated endothelium-denuded segments of the rabbit jugular vein where bradykinin elicits a constrictor response, mediated by activation of the bradykinin B(2) receptor. ACE inhibitors, including moexipril, may exert neuroprotective effects. Moexipril promoted neuronal survival in vitro and it is thought that this neuroprotective effect is due to free radical scavenging properties of the drug. ACE inhibitors can also decrease progression of renal insufficiency in patients with various underlying renal diseases. Moexipril may also have a renoprotective effect as it increased the ultrafiltration coefficient and normalized urinary protein excretion in rat models. Preclinical studies indicate that the renin-angiotensin-aldosterone system may play a role in the regulation of bone resorption and moexipril had no adverse effects on bone metabolism in animal models and the drug did not hamper the osteoprotective effects of estrogen. Reduction in left ventricular mass with moexipril in patients with hypertension was similar in magnitude to the effect of other ACE inhibitors. When investigated in hypertensive patients with an elevated cardiovascular risk, moexipril increased arterial distensibility and demonstrated antioxidative properties in addition to efficiently controlling blood pressure. Moexipril does not adversely affect serum levels of uric acid, lipids, blood glucose levels and plasma insulin levels and can be co-administered with hormone replacement therapy. Moreover, quality-of-life data suggest favorable effects of moexipril treatment in a patient population at high cardiovascular risk.
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PMID:ACE Inhibition with moexipril: a review of potential effects beyond blood pressure control. 1472 69

Moexipril was given to 35 postmenopausal women with mild and moderate hypertension, menopausal syndrome and decreased bone mineral density. Blood pressure (BP) was measured before and in 1, 3, 6, and 12 months, while ultrasonic bone densitometry was carried out before and in 12 months of moexipril use. Significant lowering of systolic and diastolic BP, reduction of severity of climacteric syndrome occurred after 1, 3 and 6 months of moexipril use, respectively. After 12 months parameters of bone densitometry in moexipril treated women became better than in control group (p<0.01). Treatment was also associated with significant improvement of quality of life, diminished reactive anxiety and depression.
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PMID:[The use of moexipril in postmenopausal women with hypertension and associated changes of bone mineral density]. 1609 58

Moexipril (7.4-15 mg/day) was given to 34, spirapril (3-6 mg/day) -- to 18 postmenopausal women with hypertension and metabolic syndrome for 16 weeks. Hydrochlorthiazide was added when therapy was not sufficiently effective. Both angiotensin converting enzyme inhibitors had similar hypotensive activity: blood pressure normalized in 71 and 61% of moexipril and spirapril treated women, respectively. Both drugs promoted normalization of metabolism of lipid (lowering of levels of cholesterol, atherogenic lipoproteins and triglycerides) and carbohydrates (lowering of hyperinsulinemia). Patients with postmenopausal metabolic syndrome had elevation of leptin level up to 27.5+/-5.5 pg/ml. Moexipril and spirapril caused lowering of elevated levels of leptin. These drugs did not affect levels of sex hormones. They exerted vasoprotective (normalization of endothelium dependent and independent vasodilatation) and nephroprotective (attenuation and normalization of microalbuminuria) effects. Thus spirapril and moexipril are effective in treatment of hypertension in patients with postmenopausal metabolic syndrome.
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PMID:[Comparative efficacy and safety of contemporary Angiotensin converting enzyme inhibitors moexipril and spirapril in women with postmenopausal metabolic syndrome]. 1647 9

Moexipril is a long-acting, non-sulfhydryl angiotensine-converting enzyme inhibitor. It is used for treatment of arterial hypertension. Moexipril is the prodrug, yielding moexiprilat by hydrolysis of an ethyl ester group. Moexiprilat is the metabolite responsible for the pharmacological effect after moexipril administration. Samples of rat and human microsomal preparations exposed to moexipril treatment were analyzed by HPLC using octyl silica stationary phase and isocratic elution. To detect moexipril and moexiprilat the separation was monitored by both ultraviolet and mass specific detection. The rat liver microsomal preparation was more effective to in producing moexiprilat than the similar one derived from human liver cell lines. While additional potential metabolites of moexipril were suggested by computer-modeling, moexiprilat was the sole metabolite detected after microsomal treatment.
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PMID:Metabolism of moexipril to moexiprilat: determination of in vitro metabolism using HPLC-ES-MS. 1726 29

Angiotensin-converting enzyme (ACE) inhibitors today are the standard therapy of patients with myocardial infarction and heart failure due to their proven beneficial effects in left ventricular remodeling and left ventricular function. ACE inhibitors have also been demonstrated to lead to regression of left ventricular hypertrophy (LVH). It is believed that the mechanism of action of LVH regression with ACE inhibitors arises from more than simple blood pressure reduction. LVH is an important risk factor for cardiovascular disease morbidity and mortality independent of blood pressure. Moexipril hydrochloride is a long-acting, non-sulfhydryl ACE inhibitor that can be taken once daily for the treatment of hypertension. Moexipril has now also been demonstrated to have beneficial effects on LVH and can lead to LVH regression.
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PMID:Moexipril and left ventricular hypertrophy. 1758 72