Angiotensin‐converting Enzyme Inhibition as First‐line Treatment for Hypertension

Abstract

1. Perindopril (4 mg) was compared with atenolol (50 mg), captopril (25 mg b.d.) or a diuretic (hydrochlorothiazide 50 mg and amiloride 5 mg) in three studies involving a total of 503 hypertensive patients with a diastolic blood pressure (DBP) of 95-125 mmHg.2. A 4 week single-blind placebo period preceded 12 weeks of active treatment. Dose titration was at weeks 4 and 8 if supine DBP >90 mmHg. The dose was doubled and if necessary a diuretic was added in the atenolol or captopril comparisons, and atenolol was added in the diuretic study.3. The fall in supine blood pressure (BP) was 27/ 17 mmHg with perindopril and 21 / 16 mmHg for atenolol. Monotherapy controlled 55% of patients on perindopril and 48% on atenolol, increasing to 78% and 58% with the addition of hydrochlorothiazide, respectively. Captopril caused a BP fall of 19/ 12 mmHg compared with 27/18 mmHg for perindopril, with 49% of both groups being controlled on monotherapy.4. Diuretic addition produced a greater antihypertensive effect with perindopril (75%) compared with 57% for captopril in achieving control. Perindopril caused a comparable fall in supine BP to the diuretic combination 27/19 mmHg and 31/ 18 mmHg, but the fall in erect systolic BP was significantly greater for the diuretic. At 3 months, 85% of the diuretic group and 78% of the perindopril group achieved the target BP. 5.A multicentre trial of 856 patients treated with perindopril(690 patients treated for 1 year or more) has shown that BP control is maintained in the long term with a low incidence of side-effects (7.9%) causing withdrawal from treatment. These studies demonstrate that perindopril compares favourably with standard first-line therapy for mild to moderate hypertension.

Design, Synthesis, and Evaluation of Novel Phenolic Acid/Dipeptide/Borneol Hybrids as Potent Angiotensin Converting Enzyme (ACE) Inhibitors with Anti-hypertension Activity

“…Nowadays, the angiotensin converting enzyme (ACE) inhibitors (e.g., Capoten (captopril), Vasotec (enalapril), Prinivil, or Zestril (lisinopril), etc.) have been considered as first-line drugs for the treatment of hypertension and myocardial infarction [ 5 , 6 ]. However, it was found that any single currently used ACE inhibitor cannot completely prevent and cure hypertension.…”

Oxytocin Elicits Itch Scratching Behavior via Spinal GRP/GRPR System

“…These findings caught our attention. We consulted the relevant literatures and found that it has been well reported that central administration of OT elicits strong scratching and grooming behaviors in rodents (Meisenberg and Simmons, 1982;Van Wimersma Greidanus et al, 1990;Thurston, 1992;Schorscher-Petcu et al, 2010;Yaksh et al, 2014). For example, intracerebroventricular injection of a high dose (1 nmol) of OT caused behavioral symptoms such as grooming, moving, foraging and squeaking (Delanoy et al, 1978).…”

“…It has been well documented that central administration of OT elicits strong scratching and grooming behaviors in rats (Van Wimersma Greidanus et al, 1990;Yaksh et al, 2014) and mice (Meisenberg and Simmons, 1982;Thurston, 1992;Schorscher-Petcu et al, 2010). When injected into the brain or spinal cord, OT at a dose of 1 nmol caused a behavioral syndrome characterized by grooming, moving, foraging, and squeaking in mice or rats (Delanoy et al, 1978;Yaksh et al, 2014), whereas a lower dose (<0.1 nmol) of OT produced scratching, rather than grooming, as the predominant symptom of behavioral arousal in mice (Meisenberg and Simmons, 1982;Schorscher-Petcu et al, 2010).…”