拜新同联合依那普利治疗老年顽固性高血压疗效观察

目的观察拜新同联合依那普利治疗老年顽固性高血压的临床疗效。方法60例老年顽固性高血压患者给予拜新同30～60mg 1次／d,依那普利5-10mg 2次／d,治疗8周后采取自身对照比较治疗前后血压指标,评估其临床疗效。结果服药4周,总有效率76．67％,服药8周,总有效率91．67％。结论拜新同联合依那普利治疗老年顽固性高血压疗效较好。     

硝苯地平控释片的单药降压控制率和治疗依从性

目的 :观察硝苯地平控释片降压控制率和治疗依从性。方法 :硝苯地平控释片 ( A组 ) 4 5例、依那普利 ( B组 ) 4 2例、硝苯地平片 ( C组 ) 4 3例进行 12 m o前瞻性对比研究。结果 :A,B,C组降压谷峰值比率分别为 ( 10 1± 12 ) % ,( 65± 9) % ,( 3 6±9) % ;单药降压控制率分别为 93 .3 % ,76.2 % ,65 .1% ;治疗依从性比率分别为 86.6% ,5 4 .8% ,3 4 .9% ;A,B,C组的单药降压控制率、治疗依从性比率均与谷峰值比率呈正相关关系 ,r分别为 0 .83 ,0 .79,0 .80 ,0 .76,0 .78,0 .77。A组明显优于 B,C组 ( P<0 .0 5 - 0 .0 1)。治疗依从性差原因中 ,因无效、病情加重、不良反应、漏服药的发生率 ,A组明显少于 B,C组 ( P<0 .0 5 -0 .0 1)。仅降压费用高一项 A组更为明显。结论 :硝苯地平控释片单药降压控制率高、不良反应少、治疗依从性好 ,治疗效能和价格比可能是比较优越的     

伴有重度肾功能不全的慢性肾小球肾炎患者可以应用依那普利吗？

目的 探讨依那普利对伴有重度肾功能不全的慢性肾小球肾炎患者的有效性和安全性.方法慢性肾小球肾炎患者46例,以内生肌酐清除率(Ccr)分为两组.高Ccr组Ccr 50 ml·min-1以上,13例;中Ccr组Ccr 25～50 ml·min-1,17例;低Ccr组Ccr 25 ml·     

The Clinical Effect of Valsartan on Blood Pessure of Patients withEssential Hypertension

The objective of the current study was to study the effect of Valsartan on blood pressure(BP) of patients with mild to moderate essential hypertension,the untoward effect of drugs and resistance of drugs. 1 Subject and Method1.1 Subject 64 patients with mild to moderate essential hypertension were involved in our study,34 female,30 male,aging from 34 to 66 years(average years:53±5.8years).Diagnosis criteria for hypertension adopted by WHO was used with hypertension ranged from 140～179/90…     

The role of fixed-dose combinations in the management of hypertension: focus on lercanidipine-enalapril

Achieving optimal blood pressure (BP) control is the most important single issue in the management of hypertension, and in most patients, it is difficult or impossible to achieve target levels with one drug. Blocking two or more regulatory systems provides a more effective and more physiologic reduction in BP, and current guidelines have recommended the use of combination therapy as first-line treatment, or early in the management of hypertension. Fixed-dose combination therapy is an efficacious, relatively safe and cost-effective treatment option in most patients with essential hypertension. Of note, the once-daily administration of a fixed-dose enalapril/lercanidipine, by bringing together two distinct and complementary mechanisms of action, reduces BP effectively and has the potential for improved target organ protection relative to either class agent alone.     

Effects of Enalapril Maleate on Plasma Level of Inactive Renin in Renovascular Hypertension

Changes in plasma levels of active and inactive renin after the treatment with enalapril maleate (MK-421), a new angiotensin converting enzyme inhibitor, were studied in five patients with renovascular hypertension(RVH) due to unilateral renal artery stenosis. The dosage was increased when the blood pressure (BP) was not normalized for more than 3 days. Blood sampling was performed before, and 5 hours and 24 hours after the first administration, and on the 3rd day with each dosage. Active and inactive renin concentrations (ARC and IRC) showed a reciprocal change in 4 cases, 5 hours after the first dose. In the chronic treatment, ARC and IRC before the morning dose did not change apparently until the BP was normalized, when both ARC and IRC were evidently increased. It was suspected that a conversion from inactive to active renin may occur in the patients with RVH, when the active renin secretion is stimulated suddenly by the first dose of MK-421. The chronically diminished perfusion pressure in the kidney may stimulate the secretion of inactive renin, but the decrease in endogenous angiotensin II may not.     

Effect of Enalapril Treatment on the Heart of Normal Rats

Previous experiments showed that enalapril (EN) treatment as well as enalaprilic acid, when added to the perfusion bath, diminish the inotropic response of the papillary muscles to isoproterenol (ISO). The main objective of this study was to evaluate, in normal rats, the effect of EN on basal contractility and inotropic response to ISO on the whole perfused ventricles (Langendorff preparation). Blood pressure (BP), increase in body weight (IBW), ventricular weight/body weight ratio (R) and concentration of ventricular proteins and DNA were also analyzed. Five groups were studied: EN10: 5 mg/kg/day, 10 days; EN21(L): 5mg/kg/day, 21 days; EN21(H): 15 mg/kg/day, 21 days. C10 and C21 were untreated controls. Cardiac contractility was evaluated by the maximal developed pressure, maximal rate of rise of pressure and maximal velocity of relaxation; no changes were found due to EN treatments either on basal conditions or on ISO stimulation. Significant differences (p<0.05 vs C21) were: lower BP and R in EN21(L) and EN21(H), slower IBW in EN21(H), decreased ventricular DNA in EN21(H). In conclusion, daily treatment for ten or twenty one days with enalapril does not change either basal cardiac contractile performance or inotropic response to ISO in the Langendorff preparation. Longterm treatment with EN seems to modify nuclear processes involved in cardiomyocite DNA content     

Benefits of delapril in hypertensive patients along the cardiovascular continuum

Angiotensin-converting enzyme inhibitors (ACEIs) are the first-line therapy for the treatment of hypertension. However, not all ACEIs are equal. Delapril is a nonsulfhydryl ACEI with unique properties. Delapril has a high lipophilicity and weak bradykinin potentiating action. As a result, delapril has a more potent inhibition capacity of vascular wall angiotensin-converting enzyme activity and a lower incidence of cough than enalapril or captopril. With regard to efficacy, delapril has a long-lasting antihypertensive effect with a trough/peak ratio that is in the upper range of different ACEIs and a positively high smoothness index. Thus, delapril effectively and smoothly reduces blood pressure over 24 h. Moreover, the benefits of delapril are not limited to hypertensive patients, but also in those with microalbuminuria, left ventricular hypertrophy, myocardial infarction or heart failure; delapril appears to be effective and well tolerated.     

Potential effect of enalapril on clomipramine metabolism

In two patients treated for hypertension with enalapril for more than 12 months, clomipramine was introduced in small to moderate doses for the treatment of dysthymic disorders. Rapid improvement of depressive symptoms was noted, which was followed by signs of antidepressant overdosage. The blood levels of clomipramine and desmethylchlomipramine were high. After reducing the dose, the symptoms resolved and the blood level of antidepressant returned to the usual therapeutic range. Enalapril would appear to reduce the clearance of clomipramine; the association enalapril + clomipramine does not appear to modify blood pressure.     

The effect of the angiotensin converting enzyme inhibitor, enalapril, on exercise tolerance and abnormalities of limb blood flow and respiratory function in patients with severe heart failure

Ten patients with severe (NYHA III) heart failure were comparedwith 10 age-matched healthy subjects in terms of oxygen uptakeand minute ventilation at rest and during exercise and calfand forearm blood flow measured by venous occlusion plethysmographyat rest and after a standardized exercise test. Patients performeda symptom-limited treadmill exercise test and were then treatedwith enalaprilfor 5 weeks; the various measurements were repeatedat weekly intervals. Oxygen consumption (VO₂) at rest was similar in the patientsand controls. During exercise, patients VO₂, tended to be lowerat each workload, but this was not affected by enalapril treatment.Minute ventilation was higher at rest and at each exercise stagein the patients than in the control subjects, and this was significantlyreduced by enalapril treatment. Compared with the controls (2.94±0.10 and 2.93±0.20ml, 100 ml^–1min^–1) forearm and calf blood flow measuredby venous occlusion plethysmography was reduced at rest in thepatients (1.34±0.18 and 1.24±0.11 ml. 100 ml .min^–1min^–1), but was significantly increased byenalapril treatment (1.73±0.15 and 1.60±0.16 ml.100 ml^–1 . min^–1). Submaximal leg exercise to afixed VO₂, showed attenuation of the normal vasoconstrictionin the forearm and vasodilatation of the calf; enalapril treatmentchanged these responses significantly towards normal but a markedabnormality of flow pattern persisted.