Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of captopril treatment on platelet angiotensin II levels was evaluated in 12 patients with essential hypertension. Captopril significantly lowered (p less than 0.01) mean arterial blood pressure in seven patients (Group 1) and was ineffective in five (Group 2). In Group 1, a marked decrease in plasma angiotensin II levels in both the supine (from 5.5 +/- 0.5 to 2.8 +/- 0.9 pg/ml) and the upright positions (from 17.5 +/- 4.7 to 3.9 +/- 1.6 pg/ml; p less than 0.0025) and a significant increase in platelet angiotensin II levels (from 10.5 +/- 5.3 to 22.4 +/- 17 pg/ml; p less than 0.05) after captopril treatment was observed. In Group 2, no variation was found in plasma angiotensin II levels, whereas platelet angiotensin II levels increased slightly (from 10.8 +/- 3.1 pg/ml to 16.9 +/- 5.2 pg/ml; NS). These findings suggest that the decrease in plasma angiotensin II levels can lead to an increase in platelet angiotensin II receptors or can lead to angiotensin II production in platelets through activation of a feedback mechanism. The second hypothesis suggests that platelets have alternative enzymatic pathways leading to angiotensin II production not inhibited by captopril.
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PMID:Effect of angiotensin converting enzyme inhibition on platelet angiotensin II content. 306 90

Combined Captopril treatment was applied in 61 patients with severe or moderately severe hypertension in patients insufficiently or not reacting to the usual combined antihypertensive therapy (3-7 kinds of drug). The combination included diuretics, beta-blockers, alpha-blockers, vasodilators, Ca-antagonists and centrally acting agents. Diuretics were used in all cases. Average duration of treatment was 8.2 months (i.e. 2-40 months). Mean systolic pressure prior to Captopril treatment was 202.4 mm Hg (S.D. +/- 27.6), while the diastolic 122.0 mm Hg (S.D. +/- 11.3). During combined Captopril treatment the average values were 154.2 mm Hg (S.D. +/- 18.8) and 97.6 mm Hg diastolic pressures (S.D. +/- 10.7), the difference being significant (p less than 0.001). Refractory hypertension occurred in three middle-aged female patients in response to combined Captopril treatments. Captopril treatment had to be discontinued for the appearance of side-effects (severe skin symptoms) only in a single case. A minor deterioration of renal functions was observed in three patients (in one bilateral renovascular, and in two essential hypertension). Serum creatinine value and renal functions of four patients showed significant improvement as a result of combined Captopril treatment. During combined Captopril treatments (also with a diuretic) two patients had so severe hypokalaemia that they needed potassium substitution or administration of a potassium-saving diuretic.
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PMID:Combined captopril treatment in severe and moderately severe hypertension resistant to therapy. 307 2

The hypotensive effect of captopril was assessed in patients with essential hypertension. Captopril-induced fall in arterial blood pressure was shown to be due to a decrease in total peripheral resistance. Treatment with captopril improved considerably physical stress tolerance, its combinations with a diuretic agent being particularly effective.
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PMID:[Effect of captopril on hemodynamics and physical exertion tolerance in patients with arterial hypertension]. 329 12

The suggestion has been made that the Okamoto strain of spontaneously hypertensive rats (SHR) shares some features with a subgroup of patients with essential hypertension, called nonmodulators. One feature of nonmodulators is a renal blood flow response to angiotensin II (ANG II) that is blunted on a high salt diet; the blunted renal vascular response is corrected by converting enzyme inhibition. Renal blood flow (electromagnetic flowmeter) and pressor responses to graded ANG II doses (5-300 ng) were assessed in 24 SHR and 24 Wistar-Kyoto rats (WKY) ingesting 1.6% Na. In comparison to WKY, blood pressure was higher in SHR (155 +/- 4 vs 106 +/- 2 mm Hg; p less than 0.001), renal blood flow was lower (6.9 +/- 0.5 vs 8.2 +/- 0.4 ml/min/g; p less than 0.05), and the pressor response to ANG II was enhanced, (p less than 0.0005) but the renal vascular response was blunted (p less than 0.005). Captopril (1-30 mg/kg) reduced blood pressure more in SHR than in WKY but increased renal blood flow similarly in both strains. The blunted renal vascular response to ANG II in SHR was reversed by captopril, but inhibition of converting enzyme in the kidney did not parallel systemic inhibition. Maximum blockade of converting enzyme in the kidney appears to require a larger captopril dose than is required for systemic inhibition. These results suggest that the renal blood supply in SHR also shares some of the characteristics of nonmodulators and that the action of captopril on the renal blood flow probably reflects reversal of inappropriate intrarenal ANG II formation.
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PMID:Differential pressor and renal vascular reactivity to angiotensin II in spontaneously hypertensive and Wistar-Kyoto rats. 329 92

The results of clinicoinstrumental investigations in 33 patients with coronary heart disease and coronary heart disease combined with essential hypertension complicated by stage I-II cardiac insufficiency showed that therapy with captopril at a daily dose of 25-75 mg resulted in the correction of cardiac insufficiency in 84% of the patients, with a hypotensive effect in 80%. Captopril improved myocardial contractility, decreased pressure in the pulmonary artery and total peripheral vascular resistance and produced no major side-effects.
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PMID:[Captopril in the treatment of mild cardiac insufficiency in combination with arterial hypertension]. 329 82

The effects of captopril monotherapy and combination therapy with thiazide diuretics or with methyldopa on glucose tolerance test (GTT) were investigated in 71 diabetic hypertensives. After the baseline evaluation, captopril (37.5-75 mg/day) was given. GTT and insulin assay were performed again between 10 and 12 weeks after the initiation of captopril therapy. We also studied the effects of chronic captopril therapy (6-12 months) on GTT in patients with essential hypertension. Captopril was well tolerated in all patients and no adverse reactions were observed. Chronic captopril therapy produced a significant (p less than 0.01) fall of blood pressure in all patients. There was no significant deterioration of the insulinogenic index or the time course curves of plasma glucose and insulin after GTT. These results indicate that captopril therapy does not affect glucose metabolism. Thus captopril may have an advantage for clinical use in hypertensive patients with or without impaired glucose metabolism.
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PMID:Glucose metabolism during captopril mono- and combination therapy in diabetic hypertensive patients: a multiclinic trial. 330 Oct 86

Renal scintigraphy with [99mTc]diethylenetriaminepentaacetic acid (DTPA) and/or sodium-iodine-131-o-iodohippurate (HIP) was performed before and after an oral dose of captopril (50 mg) in 18 patients with renovascular hypertension (RVH) due to renal artery stenosis (RAS) and 18 controls. In every patient with RVH, captopril induced, enhanced or sustained abnormal findings on HIP scintigraphy depending on the degree of RAS. With DTPA scintigraphy, renal function decreased after captopril in ten kidneys with RVH-related RAS and adequate baseline renal function, but this phenomenon was not evident in 11 kidneys with RVH and poor renal function. Captopril did not influence HIP or DTPA studies of kidneys with patent renal arteries (patients after successful renal angioplasty, patients with essential hypertension, contralateral kidneys of patients with unilateral RVH) or ipsilateral kidneys with mild and subcritical (less than 60%) RAS in patients without hypertension and/or normal renal vein renin activity. When HIP and DTPA scintigraphy were compared in the same patients, HIP demonstrated greater sensitivity and specificity than DTPA, particularly in patients with poor renal function. HIP scintigraphy before and after a single dose of captopril may provide a rapid sensitive and minimally invasive test for screening patients with hypertension.
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PMID:Single-dose captopril scintigraphy in the diagnosis of renovascular hypertension. 330 4

The authors report three cases where captopril was used in pregnancy. This was shown to be more useful in cases of essential hypertension than in toxaemia. There was no bad side effect from the use of Captopril. It did not alter the fetal growth once the hypertension was well controlled. Using it together with other anti-hypertensives has to be thought out very carefully and it has to be used with great care. The state of the newborns at birth was satisfactory. Follow-up was without complications except for one case where was a persistent ductus. Whether captopril had any role to play in this is uncertain. Although these results are good, captopril should not be used as first choice treatment in hypertension.
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PMID:[Captopril treatment of severe arterial hypertension in pregnancy]. 331 87

In a cross-over study in 26 patients with mild to moderate essential hypertension The antihypertensive efficacy of captopril 25 mg b.i.d., nifedipine 20 mg b.i.d. and the combination both drugs in non-responders to monotherapy was compared. Of 26 captropril-treated patients 7 were non-responders and needed the addition of nifedipine; of 26 nifedipine-treated patients 3 needed additional captopril. Seven out of 26 patients treated with captopril, 22/26 patients given nifedipine and 9/10 patients receiving the combination reported side effects. In 3 nifedipine patients, 1 captopril patient and 1 patient on both drugs, treatment had to be stopped because of side effects. Captopril and nifedipine in these doses are about equally effective both after acute and chronic administration. The response-rate is somewhat higher with nifedipine, but the side effects are significantly less with captopril. There was no significant additive effect with the combination of the two drugs.
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PMID:Cross-over comparison between captopril and nifedipine. 331 37

A randomized, double-blind study was undertaken to compare atenolol and captopril as second-step agents in the treatment of essential hypertension resistant to 5 mg bendrofluazide daily. Using a cross-over technique 28 patients were administered each drug sequentially for periods of 8 weeks with an intervening washout period of 2 weeks. Both drugs produced a significant reduction in both systolic and diastolic blood pressure (P less than 0.01). Captopril was more effective than atenolol at reducing diastolic pressure (P less than 0.05), but there was no significant difference in the systolic pressure. Neither drug produced side effects of a serious nature, but untoward symptoms were more frequent with atenolol. The effect of the drugs on myocardial function was assessed by comparing pre-treatment with post-treatment left ventricular ejection fractions, both at rest and with exercise, measured by MUGA scan. The resting ejection fraction was unaffected by either drug. During exercise, on captopril, the ejection fraction showed the normal increase over the resting baseline, but on atenolol there was no such increase.
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PMID:Comparative efficacy of captopril and atenolol in moderately severe essential hypertension. 331 38


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