Neutral endopeptidase versus angiotensin converting enzyme inhibition in essential hypertension.

Détails

ID Serval
serval:BIB_886CECFB8366
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Neutral endopeptidase versus angiotensin converting enzyme inhibition in essential hypertension.
Périodique
Journal of hypertension
Auteur(s)
Favrat B., Burnier M., Nussberger J., Lecomte J.M., Brouard R., Waeber B., Brunner H.R.
ISSN
0263-6352
Statut éditorial
Publié
Date de publication
1995
Peer-reviewed
Oui
Volume
13
Numéro
7
Pages
797-804
Langue
anglais
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial - Publication Status: ppublish
Résumé
OBJECTIVE: To evaluate the antihypertensive efficacy of sinorphan, an orally active inhibitor of neutral endopeptidase EC 3.4.24.11. DESIGN: The ability of sinorphan (100 mg twice a day) to lower blood pressure was compared with that of the angiotensin converting enzyme (ACE) inhibitor captopril (25 mg twice a day) using a randomized-sequence, double-blind crossover design in 16 patients with essential hypertension. Each treatment was administered for 4 weeks and treatments were separated by a 3-week placebo period. At the end of the last phase of treatment sinorphan was combined with captopril for a further 4-week period. The changes in systolic (SBP) and diastolic blood pressure (DBP) were monitored using repeated ambulatory blood pressure monitoring. RESULTS: When given as monotherapy for 4 weeks, neither sinorphan nor captopril significantly reduced the 24-h or the 14-h daytime mean SBP or DBP. However, a significant decrease in DBP was observed during the first 6 h after the morning administration of captopril. With sinorphan only a significant decrease in night-time SBP was found. With the combined therapy of sinorphan and captopril, significant decreases both in SBP and in DBP were observed, which were sustained over 24 h. After 4 weeks of sinorphan alone or in combination with captopril, no change in plasma atrial natriuretic peptide level was found. However, urinary cyclic GMP excretion increased transiently after administration of the neutral endopeptidase inhibitor. CONCLUSIONS: Neutral endopeptidase inhibition with sinorphan has a limited effect on blood pressure in hypertensive patients when given alone. However, simultaneous neutral endopeptidase and ACE inhibition induces a synergistic effect, and might therefore represent an interesting new therapeutic approach to the treatment of essential hypertension.
Mots-clé
Adult, Aged, Angiotensin-Converting Enzyme Inhibitors, Atrial Natriuretic Factor, Blood Pressure, Captopril, Cross-Over Studies, Double-Blind Method, Female, Humans, Hypertension, Male, Middle Aged, Neprilysin, Protease Inhibitors, Thiorphan
Pubmed
Web of science
Création de la notice
29/02/2008 12:34
Dernière modification de la notice
20/08/2019 15:47
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