Captopril in hypertension

Tschollar, W. Belz, G.G. Sublingual captopril in hypertensive crisis. Lancet 1985, 2, 34-35. 

Ortega G, MoUna M, Rivera MD, Serrano C. Neutropenia inducida porbajas dosis de captopris en pacientes hipertensos sin enfermedad autoimmune asociada. [Neutropenia induced by low doses of captopril in hypertensive patients without associated autoimmune disease.) An Med Interna 1999 16(8) 436. 

AndreucciVE,ConteG, Dal Canton A, DiMinnoG,Usberti M.The causal role of salt depletion in acute renal failure due to captopril in hypertensive patients with a single functioning kidney and renal artery stenosis. Renal Failure 1987 10 9-20. 

Case, D. B., Atlas, S. A., Laragh, J. H., Sealey, J. E., Sullivan, P. A., McKinstry, D. N. Clinical experience with blockade of the renin-angi-otensin-aldosterone system by an oral converting-enzyme inhibitor (SQ 14,225, captopril) in hypertensive patients. Prog. Cardiovasc. Dis. 1978,21,195-206. 

Bain, S.C., Le Guen, C.A., Lunec, J. and Barnett, A.H. (1991). Comparison of the free radical scavenging activity of captopril versus enalapril a three-month trial in vivo study in hypertensive diabetic patients. J. Human Hypertens. 5, 511-515. 

Bjorck JE. (1999) Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension The Captopril Prevention Project (CAPPP) randomised trial. Lancet 353 611-616. 

Moreover, whether or not hypertension is caused by an elevated level of renin or other reasons, angiotensin-converting enzyme inhibitors lower both systolic and diastolic arterial pressure in hypertensive patients, and their effects are enhanced by diuretics. Angiotensin-converting drugs of this series (captopril, enalapril) are effective antihypertensive drugs used both independently and in combination with other drugs to treat all types of hypertension as well as to treat cardiac insufficiency. 

Clinical testing began in 1976 in a study in normal volunteers, in which the pressor activity of intravenous angiotensin I was inhibited by increasing oral doses of captopril ranging from 1 to 20 mg (106). The extensive clinical studies that led to its approvals have been reviewed (98,107-111). Captopril was first approved in 1981 for use in hypertensive patients poorly responsive to multidrug therapy. It received FDA approval in 1982 for heart failure and in 1985 for general use in hypertension (101). For... 

Pandey S, Anand-Srivastava MB. 1996. Modulation of G-protein expression by the angiotensin converting enzyme inhibitor captopril in hearts from spontaneously hypertensive rats relationship with adenylyl cyclase. Am J Hypertens 9 833-837. 

The pioneer drug, captopril, had a relatively short duration of action. Nonetheless, with sublingual administration it is used to elicit beneficial hemodynamic and clinical effects in hypertensive crises, acute myocardial ischemia, and acute CHF. Several long-acting analogue drugs are used nowadays as a first-choice therapy in cardiovascular diseases, and their minor differences have been summarized in this chapter. 

Moore TJ, Crantz FR, HoUenberg NK, Koletsky RJ, I boff MS, Swartz SL, Irvine L, Podolsky S, Dluhy RG, Williams GH. Contribution of prostaglandms to the antihypertensive action of captopril in essential hypertension. Hypertension 1981 3(2) 168-73. 

Hansson L, Lindholm LH, Niskanen L, Lanke J, Hedner T, Niklason A, Luomanmaki K, Dahlof B, de Faire U, Morlin C, Karlberg BE, Wester PO, Bjorck JE. Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension the Captopril Prevention Project (CAPPP) randomised trial. Lancet 1999 353(9153) 611-16. 

Ortega G, Molina Boix M, Vidal JB, de Paco M, del Bano MD, Ruiz F. Tratamiento con captopril de la hipertension arterial en la nefropatia lupica. [Treatment of arterial hypertension with captopril in lupus nephropathy.] An Med Interna 1992 9(2) 72-5. 

Angiotensin-converting enzjme inhibitors are widely beheved to attenuate diuretic-induced falls in plasma potassium. However, captopril 25 mg bd had no effect on plasma potassium in hypertensive patients treated with bendroflumethiazide 5 mg/day (108). 

Murdoch DL, Gillen GJ, Morton JJ, Leckie B, Murray GD, Davies DL, Mclnnes GT. Twice-daily low-dose captopril in diuretic-treated hypertensives. J Hum Hypertens 1989 3(l) 29-33. 

Captopril Collaborative Study Group. Does Captopril cause renal damage in hypertensive patients Report from the Captopril Collaborative Study Group. Lancet 1982 1 988-990. 

Mason JC, Hilton PJ. Reversible renal failure due to captopril in a patient with transplant artery stenosis case report. Hypertension 1983 5 623-627. 

FIGURE 24 Captopril, an angiotensin-converting enzyme inhibitor, is used in hypertension and congestive heart failure. 

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