Long‐term experience with captopril in severe hypertension.

Havelka, J.; Boerlin, H. J.; Studer, A.; Greminger, P; Tenschert, W; Luescher, Thomas F; Siegenthaler, W; Vetter, W; Walger, Peter; Vetter, Hans

doi:10.1111/j.1365-2125.1982.tb02060.x

Cited by 31 publications

(19 citation statements)

References 24 publications

(28 reference statements)

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“…The present study confirms others (Gavras et al 1978, Raine & Ledingham 1982, Havelka et al 1982a, Hamilton et al 1981) that captopril is an effective antihypertensive agent for the treatment of resistant hypertension in patients with renal functional impairment. The absence of reflex tachycardia in association with antihypertensive efficacy is probably related to alteration in autonomic function in hypertensive subjects (Mancia et al 1982) and to combined arteriolar and venous dilatation (Tarazi 1978, Tarazi et al 1980.…”

Section: Discussionsupporting

confidence: 91%

Captopril for Refractory Hypertension in Patients with Impaired Renal Function

et al. 1985

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The use of captopril in 19 patients with renal parenchymal disease and refractory hypertension was studied for a mean period of 12 months. There was a significant reduction in the systolic and diastolic blood pressures, with a reduction in the mean arterial pressure of 29 mmHg. The mean maintenance dose of captopril was 142 mg daily in three divided doses. All but one of the patients required a diuretic for satisfactory blood pressure control and 3 patients were also given a beta-blocker. In all patients a simplification of the previous therapeutic regimen was achieved. A significant rise in serum creatinine was noted in 2 patients, one of whom had to be withdrawn from the study. Despite the presence of renal functional impairment, proteinuria did not occur de novo nor did established proteinuria increase. Leukopenia was not noted in any of the patients in this group.

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Section: Discussionsupporting

confidence: 91%

Captopril for Refractory Hypertension in Patients with Impaired Renal Function

et al. 1985

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“…Increased serum potassium levels have been observed during ACE inhibitor therapy in patients with CRF (Bauer, 1984;Heel et al, 1980;Havelka et al, 1982). In this study of only 1 week duration no statistically significant changes in serum potassium concentration during cilazapril, given alone or in combination with nitrendipine, were observed.…”

Section: Discussionmentioning

confidence: 49%

“…In this study of only 1 week duration no statistically significant changes in serum potassium concentration during cilazapril, given alone or in combination with nitrendipine, were observed. As with other studies using the ACE inhibitors cilazapril and captopril in patients with chronic renal failure (Shionoiri et al, 1988;Havelka et al, 1982), serum creatinine Results are given as means ± s.e. mean, * P < 0.01 compared with the first day of the same period.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive effects of nitrendipine and cilazapril alone, and in combination in hypertensive patients with chronic renal failure.

Kloke¹,

Huysmans²,

Jf³

et al. 1989

Brit J Clinical Pharma

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1. It has been reported that calcium antagonists lower blood pressure more effectively in salt replete hypertensive patients with a low plasma renin activity (PRA), whereas angiotensin converting enzyme (ACE) inhibitors are more effective in salt depleted patients with a high level of PRA. An inverse relationship between the antihypertensive effects of these two groups of drugs might therefore be expected. 2. Since salt retention and inappropriately high levels of PRA are said to contribute to hypertension in patients with chronic renal failure (CRF), an additive antihypertensive effect with both drugs might also be expected in such patients. 3. To test these hypotheses, we investigated the acute and chronic antihypertensive effects of the calcium antagonist nitrendipine and the new ACE inhibitor cilazapril, given alone, and in combination, in a double‐blind, randomized, placebo controlled study of 11 hypertensive patients with chronic renal failure who had a mean pretreatment blood pressure of 149 +/‐ 3/96 +/‐ 2 mm Hg. Patients received nitrendipine 10 mg, cilazapril 1.25 or 2.5 mg depending on creatinine clearance, or placebo once daily orally. Nitrendipine and cilazapril were also combined at the same doses. 4. Nitrendipine and cilazapril were equally effective, with a maximal acute reduction of mean arterial pressure (MAP) of 5.3 +/‐ 1.8% and 8.0 +/‐ 1.9%, and after 1 week of treatment 5.0 +/‐ 2.4% and 8.1 +/‐ 1.8%, respectively. In individual patients no inverse relationship between the blood pressure responses to the two drugs was found.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Only seven patients (14%) developed grade 3 symptoms, and these responded to dose reduction or withdrawal of marimastat. The other common side effects were taste change and cough, both of which are known side effects of captopril (Havelka et al, 1982).…”

Section: Discussionmentioning

confidence: 99%

Combination antiangiogenesis therapy with marimastat, captopril and fragmin in patients with advanced cancer

et al. 2004

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Marimastat, low molecular weight heparins and captopril have antiangiogenic activity in vitro and in animal models. We studied the safety and efficacy of the combination of these drugs in patients with advanced cancer. In all, 50 patients were enrolled. Captopril was given orally at a dose of 50 mg bd daily. Fragmin was administered as a daily subcutaneous injection of 200 units kg À1 for the first 28 days and 5000 units thereafter. Marimastat was given at 10 mg bd orally. Serum, plasma and urinary angiogenic factors were measured at baseline and after 1 month of treatment. Inhibition of release of tumour necrosis factor alpha (TNF-alpha) from peripheral lymphocytes was used as a surrogate pharmacodynamic end point. There was one case of haemorrhagic stroke and one upper gastrointestinal haemorrhage. The commonest toxicity was myalgia. One of 10 patients with renal cancer had a partial response, and three patients had a prolonged period of stable disease. The treatment significantly inhibited phytohaemagglutinin (PHA)-stimulated TNF-alpha release from patient's lymphocytes. The combination of marimastat, fragmin and captopril is well tolerated and has in vivo activity. Inhibition of PHA-stimulated TNF-alpha release from lymphocytes is a surrogate pharmacodynamic marker of metalloprotease inhibition.

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Long‐term experience with captopril in severe hypertension.

Cited by 31 publications

References 24 publications

Captopril for Refractory Hypertension in Patients with Impaired Renal Function

Captopril for Refractory Hypertension in Patients with Impaired Renal Function

Antihypertensive effects of nitrendipine and cilazapril alone, and in combination in hypertensive patients with chronic renal failure.

Combination antiangiogenesis therapy with marimastat, captopril and fragmin in patients with advanced cancer

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