Evaluation of captopril for the management of hypertension in autonomic dysreflexia: A pilot study

Esmail, Zahida; Shalansky, Karen F.; Sunderji, Rubina; Anton, Hugh; Chambers, Keith; Fish, William R.

doi:10.1053/apmr.2002.30911

Cited by 42 publications

(24 citation statements)

References 22 publications

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“…Clients who experience AD with ejaculation may need to consider the use of prophylactic medication in order to dampen the severity of blood pressure rise or modify the symptoms of AD. The use of medication such as nifedipine or captopril has been discussed as a treatment for acute AD (31)(32)(33). Future research from our laboratory will explore a prophylactic antihypertensive that may be helpful in managing AD associated with ejaculation.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Autonomic Dysreflexia and Silent Autonomic Dysreflexia in Men With Spinal Cord Injury Undergoing Sperm Retrieval: Implications for Clinical Practice

Ekland

Krassioukov

McBride

et al. 2008

The Journal of Spinal Cord Medicine

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Background/Objective: To determine the incidence of symptomatic autonomic dysreflexia (AD) and asymptomatic autonomic dysreflexia (silent AD) in men with spinal cord injury (SCI) undergoing sperm retrieval procedures. Design: Descriptive study. Methods: Thirteen men underwent cardiovascular monitoring during vibrostimulation (or self-stimulation) to the point of ejaculation. Cardiovascular results were compared with objective and subjective signs of AD to determine the incidence of symptomatic and silent AD. Past history and knowledge of AD were correlated to participants' experience of AD in the clinical setting. Outcome Measures: Change in diastolic and systolic blood pressure is the primary outcome data that will be compared to AD history and data from each participant's questionnaire. Results: Twelve of the 13 men experienced a rise in blood pressure consistent with AD (defined as an increase in blood pressure . 20 mmHg). Men with incomplete tetraplegia were able to identify symptoms associated with AD, and those with complete tetraplegia did not experience symptoms. Eleven of the 13 men knew that sexual activity could cause AD; however, only 2 of the 13 men acknowledged a history of AD with sexual activity and/or ejaculation. Conclusions: Symptomatic and silent AD occur frequently during sperm retrieval in men with SCI above T6. Knowledge and past history of AD are not accurate indicators of who will experience AD with sexual activity and/or ejaculation.

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Section: Discussionmentioning

confidence: 99%

Incidence of Autonomic Dysreflexia and Silent Autonomic Dysreflexia in Men With Spinal Cord Injury Undergoing Sperm Retrieval: Implications for Clinical Practice

Ekland

Krassioukov

McBride

et al. 2008

The Journal of Spinal Cord Medicine

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“…Although successful for the treatment of acute AD, 33,50 its ability to prevent AD in prophylaxis during sexual activities remains unknown. Knowing that it has an initial hypotensive effect, its prophylactic use must be commended with care on tetraplegic individuals showing resting hypotension.…”

Section: Discussionmentioning

confidence: 99%

“…Published case reports support its effectiveness for the acute and chronic treatment of AD in individuals with SCI. 24,25,50,52,53 It may be a good candidate as a prophylactic treatment of AD in the context of sexual activities.…”

Section: Discussionmentioning

confidence: 99%

“…Captopril is an angiotensin- Sexual function and autonomic dysreflexia F Courtois et al converting enzyme inhibitor, which blocks the renin-angiotensinaldosterone system and causes a reduction in peripheral arterial resistance, without changing cardiac output. Esmail et al 50 found that the drug significantly reduced SBP during AD in four out of five participants, one requiring rescue therapy with nifedipine.…”

Section: Treatment Of Ad In Other Conditionsmentioning

confidence: 98%

“…Following the warning concerning the increased risks of cardiac conditions with sublingual nifedipine, Esmail et al 50 assessed the effectiveness of captopril sublingual. Captopril is an angiotensin- Sexual function and autonomic dysreflexia F Courtois et al converting enzyme inhibitor, which blocks the renin-angiotensinaldosterone system and causes a reduction in peripheral arterial resistance, without changing cardiac output.…”

Section: Treatment Of Ad In Other Conditionsmentioning

confidence: 99%

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Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat?

Courtois

Rodrigue²,

Côté³

et al. 2012

Spinal Cord

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Study design: Systematic review. Objectives: Review the literature on the acute or prophylactic treatment of autonomic dysreflexia (AD) in the context of sexual activities. Setting: International Methods: Medline search using AD and spinal cord injury (SCI). Selected titles for AD treatment included all levels of evidence (randomized placebo control studies, case reports, literature reviews) and all years of publication. Results: Thirty-seven papers on the specific treatment of AD showed that nifedipine, prazosin, captopril and clonidine are candidates in the context of sexual activities. Prazosin, however, has an initial hypotensive effect requiring to begin treatment 12 h before intercourse, which makes it less ideal for spontaneous sexual activities. Captopril has an initial hypotensive effect and was only studied in acute AD. Its usefulness in prophylaxis remains to be demonstrated. Clonidine has successfully been used clinically for decades, but never studied in randomized control trials. Nifedipine remains the most widely studied and significant treatment of AD whether in acute or prophylactic conditions. Recent concerns suggest increased cardiovascular risks with sublingual nifedipine in non-SCI populations, but negative long-term effects have not been reported in the SCI population. Conclusion: Sexual function is a priority for men with SCI. As sexual activities, in particular ejaculation, can be a source of AD, adequate treatments and prophylaxis must be considered in the context of sexual activities. Experts must meet and conclude on the thresholds, parameters and treatments that should be considered in the long-term management of AD in the context of sexual function in men with SCI.

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Autonomic Dysreflexia

Corcos¹,

Przydacz²

2017

Consultation in Neurourology

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Evaluation of captopril for the management of hypertension in autonomic dysreflexia: A pilot study

Cited by 42 publications

References 22 publications

Incidence of Autonomic Dysreflexia and Silent Autonomic Dysreflexia in Men With Spinal Cord Injury Undergoing Sperm Retrieval: Implications for Clinical Practice

Incidence of Autonomic Dysreflexia and Silent Autonomic Dysreflexia in Men With Spinal Cord Injury Undergoing Sperm Retrieval: Implications for Clinical Practice

Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat?

Autonomic Dysreflexia

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