Captopril and Frusemide in Severe Drug-Resistant Hypertension

White, N J; Yahaya, Haliru; Rajagopalan, B.; Ledingham, J. G. G.

doi:10.1016/s0140-6736(80)90002-1

Cited by 49 publications

(12 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the combination was more effective than monotherapy in lowering blood pressure, frequent dosing was required for adequate blood pressure control 11. In the present study, the combination of long acting drugs of the two classes, namely amlodipine and lisinopril, reduced blood pressure more than either drug alone even 24 hours after dosing.…”

Section: Discussionmentioning

confidence: 50%

Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension

Naidu

Usha

Rao

et al. 2000

Postgraduate Medical Journal

View full text Add to dashboard Cite

Angiotensin converting enzyme (ACE) inhibitors and dihydropyridine calcium antagonists are well established and widely used as monotherapy in patients with mild to moderate essential hypertension. Earlier studies combining short acting drugs from these classes require multiple dosing and were associated with poor compliance. Availability of longer acting compounds allows once daily administration to avoid the inconvenience of a multiple daily dose. It was decided to perform a randomised double blind, crossover study with the long acting calcium channel blocker amlodipine and the long acting ACE inhibitor lisinopril, given either alone or in combination in essential hypertension. Twenty four patients with diastolic blood pressure (DBP) between 95 and 104 mm Hg received amlodipine 2.5 mg and 5 mg, lisinopril 5 mg and 10 mg, and their combination as per a prior randomisation schedule. Supine and standing blood pressure and heart rate were recorded at weekly intervals. Higher doses of both the drugs individually or in combination were used if the target supine DBP below 90 mm Hg was not achieved. There was a significant additional blood pressure lowering eVect with the combination when compared either with amlodipine or lisinopril alone. Five mg amlodipine and 10 mg lisinopril monotherapy achieved the target blood pressure in 71% and 72% patients respectively. The combination of 2.5 mg amlodipine with 5 mg lisinopril produced a much more significant lowering of blood pressure in a higher percentage of patients than that with an individual low dose. (Postgrad Med J 2000;76:350-353)

show abstract

Section: Discussionmentioning

confidence: 50%

Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension

Naidu

Usha

Rao

et al. 2000

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

“…The first converting enzyme inhibitory drug was first generally used in what now would be regarded as large doses (up to 450 mg a day) in the treatment of severe or renovascular hypertension frequently in combination with a diuretic (Ferguson et al, 1977;Atkinson et al, 1980, Brunner et al, 1980White et al, 1980;Heel et al, 1980;Case et al, 1982). The fall in blood pressure is due to an arteriolar dilatation giving a reduction in peripheral resistance (Tarazi et al, 1980).…”

Section: Angiotensin Converting Enzyme Inhibitorsmentioning

confidence: 99%

The management of hypertension.

Prichard¹,

Owens²

1986

Brit J Clinical Pharma

View full text Add to dashboard Cite

“…Indeed, precipitous falls in pressure can occur when renin and angiotensin II are very high as in some patients with malignant phase hypertension, or after intensive diuretic therapy. [11][12][13] Salt-depleted normal subjects show similarly enhanced responses to inhibition of converting enzyme. 12 When captopril is administered to patients with renovascular hypertension, many of whom have increased plasma levels of renin and angiotensin II, there is an initial fall in blood pressure proportional both to the plasma concentration of renin and angiotensin II, and to the fall in angiotensin II after dosing.…”

mentioning

confidence: 97%

Converting enzyme inhibitors in hypertension and heart failure.

Dargie¹,

Ball²,

Atkinson³

et al. 1983

Heart

View full text Add to dashboard Cite

The renin-angiotensin-aldosterone system is intimately involved in the regulation of vascular tone, and is central to sodium homeostasis; the octapeptide angiotensin II, formed by the action of converting enzyme on the inactive precursor decapeptide angiotensin I, constricts arterioles, enhances sympathetic activity, and promotes sodium retention, both by direct renal actions and through the release of aldosterone.Hypertension and cardiac failure are characterised by increased peripheral vascular tone and abnormal sodium and water excretion, though to what extent these changes reflect activity of the reninangiotensin-aldosterone system is unclear. Both conr ditions respond to diuretics and vasodilators even though consequent stimulation of the reninangiotensin-aldosterone system may ensue. Not surprisingly, therefore, the recent introduction of orally active converting enzyme inhibitors' 2 has generated much renewed interest in the role of the reninangiotensin-aldosterone system in hypertension and cardiac failure. These drugs prevent the conversion of angiotensin I to angiotensin II. They may also have additional effects such as inhibition of degradation of the vasodilator peptide bradykinin. Though most of our knowledge concerning the effects of converting enzyme inhibitors in man stems from the use of captopril, preliminary work with the newer compound enalapril (MK421) suggests that it has similar pharmacological effects.3 Both drugs reduce plasma angiotensin II and aldosterone with reciprocal changes in plasma renin and angiotensin I concentrations. Sustained suppression of plasma angiotensin II has been seen using 150 mg captopril three times a day.4 Enalapril, which has a longer action, may be given less frequenly.3 The associated early fall in blood pressure is the result of reduction in peripheral vascular resistance which is probably largely, though perhaps not entirely, the result of the reduction in plasma angiotensin II since restoration of 305 the latter by infusion of exogenous angiotensin II does not reverse completely the hypotensive effects of captopril.5 With prolonged use, a further fall of pressure may occur over one to three weeks; this may be the partial result of antagonism of a slow pressor effect of angiotensin II3Thus, there may be actions of converting enzyme inhibition on the systemic vasculature other than loss of the direct vasoconstrictor effect of angiotensin II; candidates for involvement in these mechanisms include bradykinin, prostaglandins, and the sympathetic nervous system, while resetting of baroreflexes has also been suggested.' 6-8 Inhibition of bradykinin degradation by converting enzyme inhibitors could have two principal results; firstly, increased levels of bradykinin could directly result in vasodilatation; and, secondly, stimulation of prostaglandin E production could result in further vasodilatation. The evidence, however, for involvement of kinins or prostaglandins in the pharmacological effects of converting enzyme inhibitors is confficting.9 10 In hypertension,...

show abstract

Captopril and Frusemide in Severe Drug-Resistant Hypertension

Cited by 49 publications

References 9 publications

Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension

Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension

The management of hypertension.

Converting enzyme inhibitors in hypertension and heart failure.

Contact Info

Product

Resources

About