Comparison Of Captopril Research Articles

Comparison of captopril (0.5%) cream with diltiazem (2%) cream for chronic anal fissure: a prospective randomized double-blind two-centre clinical trial.

This study compared the efficacy of topical captopril with topical diltiazem in the treatment of chronic anal fissure (CAF). Fifty patients aged between 15 and 75years with CAF were included in a prospective randomized, double-blind clinical trial. They were randomly allocated to either captopril (0.5%) cream or diltiazem (2%) cream in a dose of 2cm of cream on the perianal skin every 12h for 8weeks. The intensity of pain upon defaecation was evaluated every 10days using a visual analogue scale. Bleeding on defaecation, pruritus and the presence of perianal irritation were also recorded before and during the trial. The average pain scores were lower in the diltiazem group on the 20th and 30th days. From day 40 to the end of the trial the average pain scores of the two groups did not differ significantly. There were no significant differences in bleeding or perianal irritation between the groups, but the incidence of pruritus was considerably higher in the captopril group, and at the end of the trial 45.8% of the patients in this group still suffered from pruritus. Topical captopril and diltiazem were found to be equally effective in the management of pain, bleeding and perianal irritation due to CAF, but due to the high incidence of pruritus observed with topical captopril this medication is not recommended for the treatment of CAF.

The captopril and eprosartan influence on hemodynamic parameters in rats with renovascular hypertension

The aim of this investigation is the comparison of captopril and eprosartane influence on the level blood pressure, its variability and baroreceptor reflex in normal rats and rats with vasorenal hypertension. It was shown that hypertensive rats had higher level of blood pressure, heart rate and its variability than normotensive rats. There was no relationship between arterial blood pressure and its variability in normal as well as hypertensive rats. Captopril decreased blood pressure and had no effect on variability of blood pressure. In rats with renovascular hypertension an increased baroreflex and decreased variability of heart rate was note. Eprosartan, as well as captopril, decreased blood pressure, but increased variability of blood pressure in rats with hypertension.

Comparison of Captopril and Enalapril to Study the Role of the Sulfhydryl-Group in Improvement of Endothelial Dysfunction With ACE Inhibitors in High Dieted Methionine Mice

To examine the role of sulfhydryl (-SH) group in improvement of endothelial dysfunction with angiotensin-converting enzyme (ACE) inhibitors in experimental high dose of methionine dieted rats. We compared the effects of Captopril (an ACE inhibitor with -SH group), enalapril (an ACE-inhibitor without -SH group), N-acetylcysteine (only -SH group not ACE inhibitor) on endothelial dysfunction injured by methionine-induced hyperhomocysteinemia (HHcy) in rats. Male Sprague-Dawley rats were divided randomly into seven groups: control group, L-methionine group, low dose Captopril (15 mg/kg), middle dose Captopril (30 mg/kg), high dose Captopril (45 mg/kg), enalapril (20 mg/kg), N-acetylcysteine (200 mg/kg); control group were intragastric gavaged by water and others groups were intragastric gavaged by L-methionine and drugs in water one time every day. Acetylcholine (ACh)-induced endothelium-dependent relaxation (EDR), sodium nitroprusside (SNP)-induced endothelium-independent relaxation of aortic rings were examined. Paraoxonase1 (PON1) and ACE activity, malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD) in serum were analyzed. It was found that a single intragastric gavage by L-methionine resulted in inhibition of endothelium-dependent relaxation, markedly increased the serum level of malondialdehyde and decreased the activity of PON1 and SOD, similarly decreased the level of NO in the serum; but had no effects on endothelium-independent relaxation and angiotensin-converting enzyme activity compared with the control group. Given the treatment with three doses of Captopril (15 approximately 45 mg/kg) markedly attenuated inhibition of vasodilator responses to ACh, and eliminated the increased level of malondialdehyde, the decreased level of NO, activity of PON1 and SOD in serum by single intragastric gavaged L-methionine. However, there were some significant differences among Captopril (30 mg/kg or 45 mg/kg), enalapril (20 mg/kg), and N-acetylcysteine particular in the activity of PON1 and ACE. These results suggested that Captopril can protect the vascular endothelium against the damages induced by L-methionine in rats, and the beneficial effects of Captopril may be related to attenuating the decrease in PON1 activity and NO levels. Furthermore, this protective effect may be concerned with the sulfhydryl group.

Successes and failures of current treatment of heart failure

Successes and failures of current treatment of heart failure

Comparison of captopril and ibopamine in mild to moderate heart failure.

OBJECTIVE: To determine the effects of ibopamine 100 mg three times daily compared with captopril 25 mg three times daily on exercise capacity in patients with chronic heart failure. DESIGN:...

A comparison of captopril and digoxin in the treatment of patients with mild-to-moderate chronic congestive heart failure

In a double-blind study, 116 patients (mean age, 57.6 years) with mild-to-moderate chronic congestive heart failure who were in sinus rhythm were randomly assigned to receive 25 mg of captopril were daily (up to 50 mg twice daily, if needed) plus hydrochlorothiazide (HCTZ) (group 1) or 0.1 mg of digoxin twice daily plus HCTZ (group 2) for 12 months. During a 3-to 4-week pretreatment stabilization period, group 1 received a mean of 37.7 mg of HCTZ daily and group 2 received 34.9 mg daily. After 6 weeks and 12 months of treatment, improvement was noted in both treatment groups on five measures of cardiac function: exercise tolerance, left ventricular end-diastolic diameter (LVEDD), ejection fraction, blood pressure, and heart rate. At 12 months, significantly greater improvement was noted in group 1 than in group 2 in exercise tolerance (from 329 seconds at baseline to 445 seconds at 12 months in group 1 and from 353 to 427 seconds in group 2; P < 0.05); LVEDD (from 60.5 to 56.5 mm in group 1 and from 60.3 to 57.9 mm in group 2; P < 0.05); and blood pressure (from 103.5 to 95.6 mm Hg in group 1 and from 101.9 to 97.0 mm Hg in group 2; P < 0.03). Clinical severity (New York Heart Association class) improved in both groups; 52% of the patients in group 1 and 41% in group 2 dropped an average of one functional class ( P < 0.01). The results indicate that captopril combined with a diuretic is an effective initial treatment for patients with mild-to-moderate congestive heart failure.

In men with hypertension, captopril was associated with better quality of life than enalapril

Source Citation Testa MA, Anderson RB, Nackley JF, Hollenberg NK, and the Quality-of-Life Hypertension Study Group. Quality of life and antihypertension therapy in men: a comparison of captopril with enalapril. N Engl J Med. 1993 Apr 1;328:907-13.

Quality of Life and Antihypertensive Therapy in Men -- A Comparison of Captopril with Enalapril

We conducted a multicenter trial comparing two angiotensin-converting-enzyme inhibitors to determine whether effects on quality of life during antihypertensive therapy are uniform within this pharmacologic class of agents, and to relate the effects of the drugs on quality of life to objective adverse events, such as the loss of a job or the death of a spouse. After a four-week washout period when they received placebo, 379 men with mild-to-moderately-severe hypertension were randomly assigned to receive captopril (25 to 50 mg twice daily, with or without hydrochlorothiazide) or enalapril (5 to 20 mg per day, with or without hydrochlorothiazide) for 24 weeks. Blood pressure, quality of life, and life events were monitored. Differences between treatments were evaluated by calibrating measures of quality of life with objective life events. Throughout the treatment period, no differences were found in blood pressure, frequency of withdrawal of patients from the study, or major side effects. Patients treated with captopril had more favorable changes in overall quality of life, general perceived health, vitality, health status, sleep, and emotional control (P < 0.05 for each). The changes varied according to the quality of life at base line (P < 0.001); patients with a low quality of life at base line remained stable or improved with either drug, whereas those with a higher quality of life remained stable with captopril but worsened with enalapril. The quality-of-life scales correlated with life events and symptom distress (P < 0.001), and calibration analysis indicated that differences between treatments were clinically important. Two angiotensin-converting-enzyme inhibitors, captopril and enalapril, indistinguishable according to clinical assessments of efficacy and safety, had different effects on quality of life. Calibration with life events showed that drug-induced changes are substantial and that the different effects of these two agents on quality of life can be clinically meaningful.

Influence of converting enzyme inhibition on glomerular filtration rate and proteinuria

The progression of chronic renal failure is facilitated by the presence of arterial hypertension. Antihypertensive therapy has been shown to effectively protect the kidney from continuous functional derangement [1, 2]. The degree of proteinuria has also been shown to be a prognostic factor for the progression of chronic renal insufficiency [3, 4]. Recently, experimental [5, 6] and preliminary clinical data [7] have shown that converting enzyme inhibitors are effective in slowing the progression of chronic renal failure. These drugs also have the capacity to reduce glomerular proteinuria [8, 9], and through this mechanism they also have the ability to change the rate of progression of chronic renal failure. On the other hand, the measurement of the progression of chronic renal failure remains as a matter of debate [10, 11]. The usefulness of the slopes of the reciprocal of serum creatinine has been questioned [10–12] and there seems to be general agreement in the sense that sequential measurements of isotope glomerular filtration rate or inulin clearance are the most reliable methods to determine the rate of progression of chronic renal failure. This paper contains our experience on long-term effects of the therapy with the angiotensin converting enzyme, captopril, on the glomerular filtration rate and on the rate of progression of renal insufficiency of patients with chronic renal failure and arterial hypertension. Two previous publications of our group [7, 9] contain the initial results of this study obtained during the first year of follow-up in Group 1 and the first six months in Group 2. Before switching their therapy to captopril, patients were divided in two groups: Group 1, patients with primary non-glomerular disease who exhibited a progressive decline in renal function; their blood pressure was adequately controlled by means of standard triple therapy. They were initially classified by the finding of a negative and significant slope of the reciprocal of serum creatinine. Group 2 were patients diagnosed by a renal biopsy as having a primary glomerular disease with chronic renal failure, who presented with an adequate control of their arterial hypertension with one or two standard drugs. The long-term comparison of captopril versus standard therapy on the progression of renal failure and on non-diabetic glomerular proteinuria, as well as an evaluation of the different methods employed to evaluate glomerular filtration rate are presented.

Attenuation of myocardial reperfusion injury by angiotensin converting enzyme (ACE) inhibitors: A comparison of captopril (C), zofenopril (Z) and fosinopril (F)

Attenuation of myocardial reperfusion injury by angiotensin converting enzyme (ACE) inhibitors: A comparison of captopril (C), zofenopril (Z) and fosinopril (F)

Comparison of captopril and enalapril in the treatment of hypertension in patients with non-insulin dependent diabetes mellitus and nephropathy

Eighteen patients with non-insulin dependent diabetes mellitus (NIDDM), hypertension and nephropathy were randomized to receive captopril or enalapril for 6 months. Two patients with serum creatinine of greater than 400 mumol/l had to be excluded from the study because of rapidly deteriorating renal function after starting treatment. Of the remaining patients, 7 received captopril and 9 received enalapril. Blood pressure control was achieved in about 50% of patients with either drug alone. Serum creatinine and creatinine clearance were unchanged in both groups but there was a greater tendency for the former to increase in patients with higher pretreatment values. Proteinuria was reduced at 1 month only in the enalapril group which also showed a significant elevation of serum potassium after treatment. Captopril and enalapril have only a modest antihypertensive action in patients with NIDDM and nephropathy. Their use in patients with renal insufficiency must be balanced against the risk of further aggravating the deterioration of renal function.

Aerobic capacity in chronic heart failure: A randomized long-term comparison of captopril and enoximone

Aerobic capacity in chronic heart failure: A randomized long-term comparison of captopril and enoximone

Angiotensin converting enzyme inhibitors in congestive heart failure: Overview in comparison of captopril and enalapril

In this study, the use of enalapril and captopril is compared in the treatment of congestive heart failure. Although both drugs act on the renin-angiotensin system via converting enzyme inhibition, their different chemical structures may dispose them to different pharmacologic and physiologic activity. Both drugs exert a vasodilator effect, with reduction of left and right ventricular filling pressures and aortic impedance. In short-term hemodynamic studies, the onset of action and peak effect are earlier with captopril. Enalapril has a much more gradual onset and longer duration of action. Both drugs have a shallow dose-response curve and both produce comparable hormonal changes: an increase in plasma renin activity and a decrease in aldosterone levels. Captopril also increases prostaglandin production. Long-term efficacy trials have demonstrated symptomatic improvement in patients given captopril and those receiving enalapril who were also receiving digitalis and diuretics. Baseline hemodynamics may not predict long-term improvement. There are few adverse effects for the two drugs, but their incidences differ, suggesting a relationship to chemical structure. Recent studies in congestive heart failure suggest a reduction in mortality with various drug regimens.

Contrasting hemodynamic responses in severe heart failure: Comparison of captopril and other vasodilator drugs

Four studies were conducted in 36 patients with severe chronic heart failure to compare the central hemodynamic effects of captopril (CPT) to other vasodilator agents. While CPT produced less marked increases in cardiac output than did hydralazine (n = 14), nitroprusside (n = 15), or prazosin (n = 7), it produced decreases in left ventricular filling pressures similar to nitroprusside and prazosin but more than hydralazine. CPT and isosorbide dinitrate (n = 11) produced similar decreases in systemic vascular resistance and left ventricular filling pressure. However, cardiac output increased less with CPT than with nitrates, because heart rate slowed during CPT therapy. In addition, mean right atrial pressure decreased less with CPT than with nitrates, because CPT had minimal effects on limb venous capacitance and pulmonary arteriolar resistance. Alterations in left ventricular pressure-volume relationships likely contributed to the marked decreases in left ventricular filling pressures seen with CPT. In conclusion, the central hemodynamic effects of CPT differ significantly from other vasodilator drugs used in the treatment of heart failure patients. These effects cannot be characterized simply in terms of “balanced” peripheral arterial and venous vasodilation; CPT exerts highly complex effects on peripheral vessels as well as having actions independent of its peripheral vasodilator effects.

Comparison of captopril (SQ, 14,225) with placebo in mild and moderate hypertension: Karl Engelman, Section of Hypertension & Clinical Pharmacology, Hospital of the University of Pennsylvania, 34th & Spruce, Philadelphia, Pennsylvania 19104; Martha N. Hill

Comparison of captopril (SQ, 14,225) with placebo in mild and moderate hypertension: Karl Engelman, Section of Hypertension & Clinical Pharmacology, Hospital of the University of Pennsylvania, 34th & Spruce, Philadelphia, Pennsylvania 19104; Martha N. Hill