Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For several reasons, increasing numbers of patients with hypertension are treated with angiotensin-converting enzyme inhibitors and calcium channel blockers. In a twenty-four week, double-blind, randomized, parallel study, the antihypertensive effect of lisinopril (20 to 80 mg qd) and nifedipine (20 to 80 mg bid) were compared in 21 patients. Fourteen patients received lisinopril (mean dose 35 mg), and 7 patients received nifedipine (mean dose 54 mg). By the end of week 12, 8 patients had responded (supine diastolic pressure less than or equal to 90 mg) to lisinopril and 5 to nifedipine. At the end of the study supine systolic/diastolic blood pressure was reduced from 172/104 to 149/92 mmHg with lisinopril and from 171/102 to 158/94 mmHg with nifedipine. No significant difference between the two treatments was detected. Three patients were reported to have at least one clinical adverse experience during the active treatment period, 1 in the lisinopril group and 2 in the nifedipine group. No serious clinical adverse experiences were recorded. In conclusion, lisinopril and nifedipine are both effective in reducing blood pressure in patients with mild to severe hypertension. Lisinopril qd and nifedipine slow release bid produce similar decreases in blood pressure after twelve weeks of therapy and the safety profiles of the two drugs are similar.
 ...
PMID:Evaluation of the antihypertensive effect of lisinopril compared with nifedipine in patients with mild to severe essential hypertension. 131 87

The antihypertensive effects of lisinopril 10-20 mg once daily and felodipine (extended release formulation) 5-10 mg once daily were compared in a double-blind, parallel group study of eight weeks duration involving 219 patients with mild to moderate hypertension. On lisinopril treatment sitting blood pressure fell from 166.3/102.9 +/- 17.5/5.8 mmHg to 146.7/89.7 +/- 19.5/8.7 mmHg and on felodipine blood pressure fell from 166.7/103.3 +/- 18.3/5.4 mmHg to 153.6/92.3 +/- 15.9/7.9 mmHg. The decreases in sitting systolic and diastolic blood pressures were significantly greater on lisinopril than on felodipine treatment (p = 0.019 and p = 0.033). A subgroup analysis in elderly patients (age > or = 65 years) showed that lisinopril and felodipine were equally effective in reducing blood pressure. In young subjects (age < 65 years) felodipine treatment lowered systolic blood pressure less than did lisinopril treatment (p = 0.001). Lisinopril was better tolerated than felodipine. On lisinopril treatment, reports of headache and dizziness were reduced while that of cough increased. On felodipine treatment, dizziness was reduced but reports of flushing and oedema were increased. The results show a better antihypertensive effect and better tolerability for lisinopril compared with extended release felodipine.
 ...
PMID:Efficacy and tolerability of lisinopril compared with extended release felodipine in patients with essential hypertension. Danish Cooperative Study Group. 133 Mar 86

The effect of antihypertensive treatment with lisinopril (10 to 20 mg) on left ventricular mass and diastolic function was studied in 35 patients with mild to moderate hypertension. At baseline 6 and 12 months after treatment responders to lisinopril were examined by complete echo Doppler in order to measure left ventricular mass, diastolic and systolic function. Only 30 patients concluded the study follow-up. Lisinopril successfully reduced mean blood pressure (from 122 +/- 10 to 110 +/- 11 mmHg), without modification in heart rate, and left ventricular mass index (from 145 +/- 57 to 116 +/- 42 g.m-2) at month 6, with mild additional reduction at month 12. Isovolumic relaxation time was reduced but still abnormal at months 6 and 12, whereas deceleration time significantly changed only (from 230 +/- 40 to 195 +/- 35 msec) at month 12. Our results indicate that lisinopril is more successful in reducing left ventricular mass than in improving diastolic filling.
 ...
PMID:Effectiveness of the antihypertensive action of lisinopril on left ventricular mass and diastolic filling. 133 66

The angiotensin-converting enzyme (ACE) inhibitors available today include captopril (Capoten), enalapril (Vasotec), enaloprilat (Vasotec IV), lisinopril (Prinivil, Zestril), benazepril (Lotensin), fosinopril (Monopril), and ramipril (Atace). These drugs are used in the treatment of hypertension and congestive heart failure. They also are used in treating renovascular hypertension not amenable to surgery and are being studied to decrease left ventricular size after infarction and to determine whether they slow the rate of internal hyperplasia. Angiotensin-converting enzyme inhibitors have negative inotropic and chronotropic effects. This chapter discusses the ACE inhibitors and their actions, uses, adverse effects, contraindications, and nursing implications.
 ...
PMID:Angiotensin-converting enzyme inhibitors. 157 40

In a multicenter, parallel, double-blind study, lisinopril, a new converting enzyme inhibitor, was compared with atenolol in the treatment of mild to moderate essential hypertension. Four hundred ninety patients were randomized to once-a-day treatment with lisinopril 20 mg or atenolol 50 mg for 4 weeks, and the doses of lisinopril or atenolol were increased at 4-week intervals up to 80 mg or 200 mg, respectively, if sitting diastolic blood pressure (SDBP) was not well controlled. Lisinopril and atenolol reduced SDBP to a similar extent. All reductions from baseline in sitting diastolic and systolic blood pressure were significant (p less than 0.01). Lisinopril produced a significantly greater reduction (p less than 0.01) in sitting systolic blood pressure (SSBP) than atenolol. The predominant reduction in SSBP could not be explained on the basis of age, race, or severity of hypertension. It is suggested that the increase in arterial compliance reported for converting enzyme inhibitors could explain the predominant decrease in systolic blood pressure.
 ...
PMID:Lisinopril versus atenolol: decrease in systolic versus diastolic blood pressure with converting enzyme inhibition. 165 94

We have conducted a multicentre study in patients with mild to moderate hypertension. Lisinopril monotherapy, 10, 20, or 40 mg once daily (n = 35), was compared with captopril monotherapy, 25, 50, or 100 mg twice daily (n = 35). Blood pressure assessments were conducted using both office and 24-hour ambulatory blood pressure monitoring. Area under the curve analysis of ambulatory blood pressure reductions demonstrated significant differences between once-daily lisinopril and twice-daily captopril, with lisinopril producing the most significant reduction in pressure. These therapeutic results reflect the clinical-pharmacological profile of these two angiotensin-converting enzyme inhibitors and provide important clinical implications.
 ...
PMID:24-hour activity of lisinopril: clinical advantage in blood pressure control. 165 61

The incidence of both systolic and diastolic hypertension is increased in elderly patients, therefore antihypertensive drugs are commonly used in this population. In addition to changes in blood pressure, the aging process also causes numerous changes in other physiological parameters, resulting in altered pharmacokinetic and pharmacodynamic responses to the drugs. The dosage regimens for thiazide diuretics and amiloride must be individually titrated in the elderly patient, since the elimination of these agents decreases concurrently with decreased renal function, as indicated by compromised creatinine clearance. The initial doses of the calcium antagonists should be decreased in elderly patients, since representative compounds from all 3 chemically heterogeneous classes have been shown to have decreased clearance in these patients which appears to be primarily due to the status of hepatic function in the patient. However, with verapamil, the dosage should be further decreased in association with compromised renal function. The dosage of the angiotensin converting enzyme (ACE) inhibitors should be adjusted according to renal function rather than age. Lisinopril, which is primarily eliminated unchanged, is usually given in lower doses in the elderly, and doses of both captopril and enalapril may need to be reduced, depending on renal function. While there is no need to adjust the dosage regimen for the alpha-adrenoceptor blocking drugs (prazosin, terazosin), caution should be used with the beta-adrenergic blockers, particularly the hydrophilic agents, since they are renally eliminated. Labetalol may be a suitable alternative beta-blocker for the elderly patient, since its pharmacodynamic properties of decreased systemic vascular resistance without changes in heart rate or stroke volume are preferential for the elderly patient, and its pharmacokinetics are relatively unchanged in this population. Drugs that act primarily through the central nervous system, such as clonidine, methyldopa and guanfacine, require smaller doses in the presence of renal dysfunction. In contrast, guanabenz is metabolised primarily by the liver, so it would appear to be useful in elderly patients with renal dysfunction despite the lack of studies in this population. Guanadrel, an adrenergic neuron blocking drug, also requires a dosage reduction in patients with impaired renal function. In addition to the pharmacokinetic changes that occur in the elderly patient, pharmacodynamic changes may also be anticipated due to receptor modifications. Older patients have a decrease in beta-receptor sensitivity, while alpha-receptor sensitivity does not change. When designing the dosage regimen for a senior patient with hypertension, the combination of all these variables must be considered.
 ...
PMID:Antihypertensive therapy in the aged patient. Clinical pharmacokinetic considerations. 168 70

An open, randomized, cross-over study was undertaken to assess the effects of lisinopril and nifedipine on albumin excretion, renal haemodynamics and segmental tubular reabsorption in overt diabetic nephropathy. The study consisted of a 4-week run-in period, a 3-week active treatment period, a 4-week wash-out period and a second 3-week active treatment period. Twelve patients with type 1 diabetes with albuminuria, mild to moderate hypertension and a serum creatinine level of less than 200 mumol l-1 were included. Lisinopril reduced albumin excretion from 1343 +/- 337 micrograms min-1 to 879 +/- 299 micrograms min-1 (P less than 0.01), whereas nifedipine was without effect, 1436 +/- 336 micrograms min-1 vs. 1319 +/- 342 micrograms min-1. Glomerular filtration rate (GFR) was unchanged by either drug. Both drugs increased effective renal plasma flow (ERPF) by about 20%. No differences between the drugs were observed with regard to their effect on renal haemodynamic parameters. By contrast, nifedipine exerted an inhibitory effect on several proximal tubular transport markers, whereas lisinopril was without effect. The different actions on tubular transport mechanisms exerted by lisinopril and nifedipine may contribute to the observed effect on albumin excretion.
 ...
PMID:Contrasting effects of lisinopril and nifedipine on albuminuria and tubular transport functions in insulin dependent diabetics with nephropathy. 184 21

The aim of the study was to compare efficacy and safety of quinapril and lisinopril once-daily administered in patients with mild to moderate hypertension. After a two-week placebo period, 23 patients with sitting diastolic blood pressure between 95 and 110 mmHg were randomly assigned to the therapy with quinapril 20 mg/die or lisinopril 10 mg/die for 4 weeks in a single-blind design. After 4 weeks patients with diastolic blood pressure greater than 90 mmHg were treated with a higher dose (lisinopril 20 mg/die; quinapril 40 mg/die). Therapy with lisinopril normalized 83% of patients, and quinapril 45% of patients. Lisinopril was significantly better than quinapril in reducing blood pressure after 4 and 8 weeks of active treatment. The 24 hours ambulatory blood pressure monitoring showed that quinapril failed to control blood pressure after 12 hours from the administration of the drug.
 ...
PMID:[A comparative study of the effects of lisinopril and quinapril administered once a day in essential hypertension]. 216 53

The chemistry, pharmacology, pharmacokinetics, adverse effects, and dosages of the three currently available angiotensin-converting enzyme (ACE) inhibitors are reviewed. This class of agents effectively inhibits the conversion of angiotensin I to the active vasoconstrictor angiotensin II, a hormone that also promotes, via aldosterone stimulation, increased sodium and water retention. The ACE inhibitors, therefore, are capable of lowering blood pressure primarily by promoting vasodilatation and reducing intravascular fluid volume. Captopril, the first orally active, commercially available ACE inhibitor, is a sulfhydryl-containing compound. Captopril was followed by the introduction of enalapril and lisinopril, two non-sulfhydryl ACE inhibitors. The pharmacokinetic profiles of these three ACE inhibitors differ. Captopril has rapid onset with relatively short duration of action, whereas enalapril and lisinopril have slower onset and relatively long duration of action. Captopril is an active ACE inhibitor in its orally absorbable parent form. In contrast, enalapril must be deesterified in the liver to the metabolite enalaprilat in order to inhibit the converting enzyme; this accounts for its delayed onset of action. Lisinopril does not require metabolic activation to be effective; however, a slow and incomplete absorption pattern explains the delay in onset of activity. Captopril and its disulfide metabolites are primarily excreted in the urine with minor elimination in the feces. Approximately two-thirds of an administered enalapril dose is excreted in the urine as both the parent drug and the metabolite enalaprilat; the remainder of these two substances are excreted in the feces. Lisinopril does not undergo measurable metabolism and approximately one-third is excreted unchanged in the urine with the remaining parent drug being excreted in the feces. The ACE inhibitors lower systemic vascular resistance with a resultant decrease in blood pressure. Their efficacy is comparable to diuretics and beta-blockers in treating patients with mild, moderate, or severe essential and renovascular hypertension. In those patients with severe congestive heart failure (CHF) the ACE inhibitors produce a reduction in systemic vascular resistance, blood pressure, pulmonary capillary wedge pressure, and pulmonary artery pressure. These drugs may produce improvement in cardiac output and stroke volume and, with chronic administration, may promote regression of left ventricular hypertrophy. The antihypertensive effects of the ACE inhibitors are enhanced when these agents are combined with a diuretic. Captopril and enalapril have been shown to be of particular benefits as adjunctive therapy in patients with congestive heart failure, both in terms of subjective improvement of patient symptoms, and in improving overall hemodynamic status.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Angiotensin-converting enzyme inhibitors: a comparative review. 218 39


1 2 3 4 5 6 7 8 9 10 Next >>