Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women

Koch, Brigitte; Oparil, Suzanne; Stimpel, Michael

doi:10.1038/sj.jhh.1000815

Cited by 10 publications

(4 citation statements)

References 28 publications

(47 reference statements)

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“…In placebo‐controlled multicenter trials in Europe and the United States of an 8‐ to 12‐week duration in patients with mild to moderate essential hypertension (SDBP 95–114 mmHg), moexipril was more effective than placebo. Given in single daily doses of 7.5 to 30 mg, moexipril produced sustained blood pressure control over 24 hours and decreased the SDBP from 4 to 11 mmHg over placebo, 21,22,48,49 with a response rate of 48% to 61% for those receiving moexipril 7.5 and 15 mg/d versus 29% and 34% for those receiving placebo, respectively 22 …”

Section: Clinical Experience With Moexipril In Hypertensionmentioning

confidence: 99%

Pharmacological and Clinical Profile of Moexipril: A Concise Review

Chrysant

2004

The Journal of Clinical Pharma

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Angiotensin-converting enzyme (ACE) inhibitors are effective and safe antihypertensive drugs, with the exception of the rare occasion of angioedema. These drugs have demonstrated additional cardiovascular protective effects to their blood pressure lowering, and their combination with the diuretic hydrochlorothiazide potentiates their antihypertensive effectiveness. Moexipril is a long-acting ACE inhibitor suitable for once-daily administration, and like some ACE inhibitors, moexipril is a prodrug and needs to be hydrolyzed in the liver into its active carboxylic metabolite, moexiprilat, to become effective. Moexipril alone and in combination with low-dose hydrochlorothiazide has been shown in clinical trials to be effective in lowering blood pressure and be well tolerated and safe given in single daily doses. In this review, the pharmacological profile of this drug and its clinical usefulness are discussed.

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Section: Clinical Experience With Moexipril In Hypertensionmentioning

confidence: 99%

Pharmacological and Clinical Profile of Moexipril: A Concise Review

Chrysant

2004

The Journal of Clinical Pharma

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“…The studies included participants from a wide range of medical conditions including hypertension, transient ischemic attack, coronary artery disease, proteinuria, heart failure, and organ transplant. The basic characteristics of the studies are in Table 1 15–149 . A total of 44 RCT compared ACEI with placebo, 68 RCT with ARB, and 35 RCT with CCB.…”

Section: Resultsmentioning

confidence: 99%

Angiotensin‐converting enzyme inhibitor induced cough compared with placebo, and other antihypertensives: A systematic review, and network meta‐analysis

Liang

Liu

et al. 2023

J of Clinical Hypertension

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Studies have shown that angiotensin converting enzyme inhibitors (ACEIs) are superior in primary and secondary prevention for cardiac mortality and morbidity to angiotensin receptor blocker (ARBs). One of the common side effects from ACEI is dry cough. The aims of this systematic review, and network meta‐analysis are to rank the risk of cough induced by different ACEIs and between ACEI and placebo, ARB or calcium channel blockers (CCB). We performed a systematic review, and network meta‐analysis of randomized controlled trials to rank the risk of cough induced by each ACEI and between ACEI and placebo, ARB or CCB. A total of 135 RCTs with 45,420 patients treated with eleven ACEIs were included in the analyses. The pooled estimated relative risk (RR) between ACEI and placebo was 2.21 (95% CI: 2.05–2.39). ACEI had more incidences of cough than ARB (RR 3.2; 95% CI: 2.91, 3.51), and pooled estimated of RR between ACEI and CCB was 5.30 (95% CI: 4.32–6.50) Moexipril ranked as number one for inducing cough (SUCRA 80.4%) and spirapril ranked the least (SUCRA 12.3%). The order for the rest of the ACEIs are as follows: ramipril (SUCRA 76.4%), fosinopril (SUCRA 72.5%), lisinopril (SUCRA 64.7%), benazepril (SUCRA 58.6%), quinapril (SUCRA 56.5%), perindopril (SUCRA 54.1%), enalapril (SUCRA 49.7%), trandolapril (SUCRA 44.6%) and, captopril (SUCRA 13.7%). All ACEI has the similar risk of developing a cough. ACEI should be avoided in patients who have risk of developing cough, and an ARB or CCB is an alternative based on the patient's comorbidity.

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“…The selection of a specific antihypertensive drug in these patients should be grounded on the results of trials specifically aimed at hypertension in the older woman, taking into consideration aspects of safety and tolerability. There is increasing evidence that ACE inhibitors seem to be the medications of first choice in this population, not just because they are effective, but also because they do not cause further deterioration in the parameters of the menopausal metabolic syndrome, and since they may act in synergy with estrogen replacement therapy [31,49].…”

Section: Discussionmentioning

confidence: 99%

“…After 12 weeks of treatment, an adequate antihypertensive response was documented in hypertensive postmenopausal women, without interference with hormonal treatment [49].…”

Section: The Current Pharmacologic Approachmentioning

confidence: 99%

Systemic hypertension in postmenopausal women: A clinical approach

Fisman

Tenenbaum²,

Pines³

2002

Current Science Inc

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Gender-specific differences in the incidence of cardiovascular disease have long been known, and estrogens have been considered to be responsible for this dissimilarity. Recently, the steep increase in cardiovascular risk in the no longer fertile woman has become evident. The postmenopausal metabolic syndrome is very frequent, with obesity, insulin resistance, and hyperinsulinemia, which convey increased sodium reabsorption, stimulation of the sympathetic nervous system, and smooth muscle growth. The clinical corollary of these overall changes is hypertension. Gender differences in components of the renin-angiotensin system have been shown to exist, and may play a central role in blood pressure control. In normotensive populations, plasma renin activity is significantly higher in men than in women, and is higher in postmenopausal versus premenopausal women. Two angiotensin-converting enzyme inhibitors, ramipril and moexipril, have undergone trials aimed specifically at older people with cardiovascular risk and with postmenopausal hypertension, and could be the first therapeutic choice. However, a comprehensive treatment should include nonpharmacologic measures with strong emphasis on weight normalization and regular physical activity, prevention of osteoporosis, as well as decisions on the use of estrogen replacement therapy and treatment of the menopausal metabolic syndrome. Finally, education of both patients and physicians on the nature and prognosis of untreated hypertension is crucial.

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Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women

Cited by 10 publications

References 28 publications

Pharmacological and Clinical Profile of Moexipril: A Concise Review

Pharmacological and Clinical Profile of Moexipril: A Concise Review

Angiotensin‐converting enzyme inhibitor induced cough compared with placebo, and other antihypertensives: A systematic review, and network meta‐analysis

Systemic hypertension in postmenopausal women: A clinical approach

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