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

Enalapril (20 mg daily) was used in the treatment of primary arterial hypertension in 28 patients with the WHO class I and II and diastolic blood pressure ranging from 105 to 120 mm Hg. Hypotensive effect after an initial dose of enalapril occurred in 12 patients (42.8%) in whom a decrease in blood pressure at 1 hr exceeded 10% of the basal value (from means = 169.9/109.1 to 146.7/97.9 mmHg). At 6 weeks positive hypotensive effect was found in 46% of patients. A combination of enalapril with hydrochlorothiazide (25 mg daily) in patients without normalization of the blood pressure level increased the number of the favourably treated to 64%. Of 12 patients with positive effects after the first dose of enalapril only seven patients profited from chronic enalapril monotherapy. In chronic treatment enalapril seemed to be well tolerated and side effects were only sporadic.
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PMID:[Enalapril in the treatment of primary arterial hypertension]. 254 80

Since the introduction of angiotensin converting enzyme (ACE) inhibitors into clinical use, much information has been accumulated in animal models and man regarding their effects on renal function in different disease states. Enalapril, the first nonsulfhydryl ACE inhibitor approved for general use in the United States, has demonstrated efficacy and safety in controlling blood pressure in patients with essential hypertension, renal parenchymal disease, renovascular hypertension, and diabetes with hypertension. Enalapril also appears capable of attenuating the progressive nature of renal disease in experimental models of chronic renal failure and diabetic nephropathy, perhaps through lowering intraglomerular pressures. The excellent blood pressure-lowering effects of ACE inhibitors, coupled with their potential to ameliorate renal hemodynamic abnormalities, make these compounds attractive for use in these clinical states.
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PMID:The effects of enalapril on blood pressure, renal hemodynamics, and renal function. 255 60

The presence of an intrinsic inhibitor of ACE in blood of approximately 25% of sera submitted for serum ACE assay in the diagnosis and evaluation of patients with sarcoidosis, and the common use of ACE inhibitors (captopril and enalapril) in the treatment of hypertension and congestive heart failure, stimulated these studies to compare the effects of the intrinsic and medicinal inhibitors upon serum ACE activity. Since the intrinsic ACE inhibitor in man is affected by serum dilution (inhibition is reversed) and by dialysis (inhibition becomes irreversible), these manipulations were also studied with medicinal inhibitors to provide guidelines for suspecting their presence in submitted serum samples without an accompanying history. Enalapril was found to have delayed onset of action after oral administration (1-2 hours), and was even further delayed (4 hours) when the intrinsic inhibitor also happened to be present. Inhibition by enalapril was not attenuated with refrigerated storage, with dilution or with dialysis of the serum. Captopril had a more rapid time of onset of ACE inhibition, but its inhibitory activity was markedly reduced with refrigerated storage of the serum; patients showed either a short half-life for the effect (1-4 days) or a prolonged half-life (10-17 days). Inhibitory activity of captopril was reversed following dilution of serum or following dialysis. The reversal of inhibition by captopril following dialysis, therefore, differed from the effect of dialysis on the intrinsic ACE inhibitor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of captopril and enalapril medication on the serum ACE test for sarcoidosis. 255 60

The effects of the angiotensin converting enzyme inhibitor enalapril on exercise-induced changes in blood pressure and heart rate were evaluated in 15 patients in the early stages of systemic hypertension. Multistage treadmill exercise was performed before and after eight weeks of enalapril administration, and the results of the two trials were compared. In patients at rest, enalapril decreased systolic blood pressure from 172 +/- 18 to 147 +/- 14 mmHg and diastolic blood pressure from 99 +/- 9 to 88 +/- 8 mmHg (both P less than 0.001). In patients at peak exercise, enalapril decreased systolic blood pressure from 216 +/- 13 to 195 +/- 18 mmHg and diastolic blood pressure from 106 +/- 12 to 99 +/- 12 mmHg (both P less than 0.001). There was also a significant decrease in blood pressure during the recovery period after treadmill exercise. Enalapril reduced heart rate at peak exercise (P less than 0.05), but not at rest or during recovery. Thus enalapril alleviated the response of blood pressure to exercise in hypertensive patients and may help prevent hypertensive complications during daily activities.
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PMID:Effects of enalapril on the cardiovascular response to treadmill exercise in patients with mild to moderate systemic hypertension. 255 97

A patient with scleroderma renal crisis is described. At presentation he had severe hypertension, deteriorating renal function, microangiopathic haemolytic anaemia, and elevated levels of renin, aldosterone and noradrenaline. Enalapril controlled blood pressure, stabilized renal function, lowered aldosterone and noradrenaline levels, and improved peripheral circulation. It appears that converting-enzyme inhibitors can favourably alter the outlook of this otherwise fatal disorder.
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PMID:Successful treatment of scleroderma renal crisis with enalapril. 281 41

In view of the pharmacological and chemical reasons for using ACE-inhibitors to treat diabetic hypertension, a group of 40 outpatients were treated with Enalapril. The sample consisted of 20 outpatients, 6 males, 14 females aged 48-76 (mean age 63.75), 18 of whom had type II and 2 type I diabetes and 11 under treatment by diet and hypoglycaemic drugs or insulin. All these patients presented slight or moderate essential arterial hypertension (diastolic pressure less than 115 mmHg). For about one year 17 of the patients were given 20 mg/die Enalapril and the remaining three 10 mg/die in a single morning dose. In 16 cases no other treatment was given. In 4 a non-potassium conserving diuretic was also given. Check-ups before six months into and at the end of treatment showed: a statistically significant reduction in systolic (p less than 0.05) and diastolic (p less than 0.01) pressure. In contrast no significant change was noted in heart beat, glycaemia before or after meals, body weight, glycosylated haemoglobin or any other blood chemical parameter considered. In one case only there was a slight increase in proteinuria that was however present at the start of treatment. As far as side effects are concerned there was one case of cardiac palmus during treatment and one case of coughing that regressed totally when treatment was suspended but nothing else of significance. It should be noted that the antidiabetic treatment remained unchanged throughout the period considered in most cases and at most was subjected to minimal qualitative and quantitative adjustments.
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PMID:[Prolonged treatment of hypertension in diabetic patients with enalapril. 1-year follow-up]. 282 79

The development of angiotensin-converting enzyme (ACE) inhibitors is of landmark importance in the understanding and treatment of cardiovascular disorders, particularly hypertension and congestive heart failure. Enalapril has recently joined captopril as an approved, orally active ACE inhibitor. Like captopril, it has been effective in the treatment of hypertension and congestive heart failure, with minimal adverse reactions noted. Differences in pharmacology exist between enalapril and captopril which may prove to be of clinical significance.
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PMID:Enalapril: a long-acting angiotensin-converting enzyme inhibitor. 282 41

In an eight-week, multicenter open-label study of enalapril monotherapy for mild-to-moderate essential hypertension, data for 115 of the 276 participants between the ages of 55 and 75 years (whites, n = 90; blacks, n = 25) were analyzed. These data were compared with similar data for the study subset of 92 younger patients between the ages of 21 and 45 years (whites, n = 58; blacks, n = 34). The most striking finding was the overall lack of significant differences in response between older and younger patients. There were, however, significant differences in response to therapy between the two racial groups studied. In the older group, normotension was achieved in 66% of white patients and 60% of black patients with a single daily dose of enalapril ranging from 5 to 40 mg; the group means, 13 +/- 1 mg in whites vs 22 +/- 2 mg in blacks, differed significantly (P less than 0.05). Thirty-one percent of older white patients attained normotension with a daily dosage of 5 mg, whereas only 4% of black patients in this age group did so. Only 4% of the older white patients but 24% of the older black patients reached the highest recommended daily dosage of 40 mg of enalapril. Adverse reactions occurred in 11% of the older white patients and 16% of the older black patients (a nonsignificant difference), consisting mostly of gastrointestinal discomfort, malaise, dizziness, and pruritus. There were no significant biochemical abnormalities, the only consistent change being a slight increase in mean plasma potassium from 4.34 to 4.45 mEq/L in older whites (P less than 0.05). Enalapril appeared to be generally effective and well tolerated in the management of mild-to-moderate hypertension in the older subset of patients in this study. Efficacy and tolerability data for older and younger patients were comparable.
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PMID:Efficacy and tolerability of enalapril monotherapy in mild-to-moderate hypertension in older patients compared to younger patients. 283 Sep 74

In a 24-week randomized, single-blind study Timolol (n = 63) and Enalapril (n = 57) proved to be potent and safe antihypertensive drugs. However, the effect on lipid metabolism was fundamentally different, despite the fact that the effect on total serum cholesterol did not significantly differ between the two groups. Enalapril had no adverse effect on any lipid fractions, while Timolol increased very low (VLDL) + low (LDL) density lipoprotein cholesterol by 7.6% (p less than 0.001) and total triglycerides by 34.5% (p less than 0.001), and decreased the favorable high density lipoprotein (HDL) cholesterol by 11.3% (p less than 0.001). Thus, the ratio HDL/VLDL + LDL cholesterol was reduced by 17.1% (p less than 0.001). Enalapril reduced uric acid by 3.4% (NS), while Timolol increased uric acid by 4.0% (p less than 0.05). The difference between the groups was statistically significant (p less than 0.01). The first steps in any attempt to solve the hypertension-coronary dilemma should be to take into consideration all pharmacologic effects of antihypertensive drugs.
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PMID:The effect of enalapril and timolol on blood lipids. A randomized multicenter hypertension study in general practice in Norway. 283 91

To evaluate whether hypertension is a cause or just an association with diabetic renal disease, diabetes was induced in both normotensive Wistar-Kyoto and spontaneously hypertensive rats (WKY and SHR). Animals were assessed monthly for 8 months before sacrifice. When compared to normotensive diabetic rats (WKY-STZ), hypertensive diabetic rats (SHR-STZ) had an earlier and more rapid rise in urinary albumin excretion. In addition, SHR-STZ had increased glomerular basement membrane thickness when compared to WKY-STZ or SHR. In a separate experiment, Enalapril therapy (35 mg/L) was administered in drinking water to WKY-STZ and SHR-STZ. Enalapril significantly reduced blood pressure in both animal groups, and this was associated with a decrease in urinary albumin excretion. The SHR-STZ model has accelerated nephropathy as determined by both functional and structural parameters. Angiotensin-converting enzyme inhibition is associated with a reduction in albuminuria in both hypertensive and normotensive models of diabetic nephropathy.
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PMID:Genetic hypertension accelerates nephropathy in the streptozotocin diabetic rat. 283 66


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