Trandolapril in Cushing's disease: Short-term trandolapril
treatment in patients with Cushing's disease and essential
hypertension

Zacharieva, Sabina; Torbova, S; Orbetzova, Maria; J, Vergilova; Nachev, E.; Wippermann, M.; Baurenski, Lubomir E.; Angelova-Gateva, P; Tzingilev, D

doi:10.1358/mf.1998.20.5.485705

Cited by 11 publications

(8 citation statements)

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“…[4][5][6][7]24 Treatment with an ACEI or an ARB provides normalization of SBP in 50% of HT people with CS. 6,54,55 During the study period, 60% of the dogs required treatment with an ACEI (ie, benazepril), and of these dogs, 41.9% needed an additional drug (ie, amlodipine), similar to what is described in people. 6,54 In veterinary medicine, telmisartan has proven to be effective in managing SH in cats 56 and, in combination with amlodipine, in dogs with SH refractory to treatment with ACEIs.…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

“…needed an additional drug (ie, amlodipine), similar to what is described in people. 6,54 In veterinary medicine, telmisartan has proven to be effective in managing SH in cats 56 and, in combination with amlodipine, in dogs with SH refractory to treatment with ACEIs. 57 In HT dogs with HAC, telmisartan has been shown to control SH in 40%…”

Section: Discussionmentioning

confidence: 99%

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Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment

José

Arenas

Alonso-Miguel

et al. 2020

Veterinary Internal Medicne

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Background: Systemic hypertension (SH) is common in dogs and humans with hypercortisolism and can persist after treatment. Objectives: To evaluate changes in prevalence of SH and systolic blood pressure (SBP) in dogs with pituitary-dependent hyperadrenocorticism (PDH) during the first year of trilostane treatment, its relationship with disease control and selected laboratory variables, and their response to antihypertensive treatment. Animals: Fifty-one dogs with PDH treated with trilostane Q12h. Methods: Prospective case series study. Dogs were evaluated at diagnosis (T0) and 1, 3, 6, and 12 months (T12). Dogs were classified as nonhypertensive (SBP < 160 mm Hg) or hypertensive (SBP≥160 mm Hg) and subclassified according to target organ damage (TOD) risk. Hypertensive dogs were treated with benazepril and, if control of SH was not achieved, amlodipine was added. Results: Prevalence of SH decreased from T0 (36/51) to T12 (17/37; P = .01). Changes in SBP during the study were influenced by the risk of TOD at T0. In severely hypertensive (SBP ≥ 180 mm Hg) dogs, the decrease in SBP was more pronounced whereas in normotensive (SBP < 140 mm Hg) dogs SBP increased slightly (P = .00). Blood pressure was not associated with disease control. Antihypertensive treatment was needed in 31/51 dogs, and in 13/31 dogs additional SH control with amlodipine was required. One third of nonhypertensive dogs at T0 required treatment with benazepril because SH developed during follow-up. Conclusions and Clinical Importance: In dogs with PDH, SBP should be measured at every visit, regardless of disease control or SBP at diagnosis. More than 1 drug may be necessary to manage SH in affected dogs.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment

José

Arenas

Alonso-Miguel

et al. 2020

Veterinary Internal Medicne

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“…Since upregulation of RAS may be involved in glucocorticoid induced hypertension, angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are recommended. ACEIs and ARBs ameliorate hypertension in almost 50% of hypertensive patients with Cushing’s disease (55 - 57). While adrenergic blockade and calcium channel blockers may be ineffective alone, they may be useful in combination therapy (58).…”

Section: Management Of Hypertension In Cushing’s Syndromementioning

confidence: 99%

Cushing’s Syndrome: All Variants, Detection, and Treatment

Sharma¹,

Nieman²

2011

Endocrinology and Metabolism Clinics of North America

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“…In another clinical trial, patients with Cushing's syndrome were treated for 8 days with the long-acting, nonsulfhydryl ACE inhibitor trandolapril [39]. There were seven patients with Cushing's syndrome who were gender/ age matched with seven mild-to-moderate essential hypertension patients without Cushing's syndrome.…”

Section: Pharmacologic Approaches To Cushing's Disease and Associatedmentioning

confidence: 99%

Hypertension in patients with cushing’s disease: Pathophysiology, diagnosis, and management

Sacerdote¹,

Weiss²,

Tran³

et al. 2005

Current Science Inc

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Hypertension is a very common comorbidity in patients with Cushing's disease/syndrome, resulting from the interplay of several pathophysiologic mechanisms, including stimulation of mineralocorticoid and glucocorticoid receptors as well as the associated insulin resistance, sleep apnea, and overexpression of renin-angiotensin system. Although treatment of Cushing's disease results in resolution or amelioration of hypertension in these patients, a significant proportion of patients do not achieve complete cure or require a prolonged period of time for complete response to therapy. Therefore, therapeutic strategies for Cushing's-specific hypertension are necessary to decrease morbidity and mortality associated with this disease. In this review, we discuss the pathophysiology of hypertension in patients with Cushing's disease, highlighting the therapeutic options, including the exciting new developments in the role of peroxisome proliferator-activated receptor (PPAR)-g agonists in the management of this patient population.

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Trandolapril in Cushing's disease: Short-term trandolapril treatment in patients with Cushing's disease and essential hypertension

Cited by 11 publications

References 0 publications

Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment

Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment

Cushing’s Syndrome: All Variants, Detection, and Treatment

Hypertension in patients with cushing’s disease: Pathophysiology, diagnosis, and management

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