Document Detail


Chronic inhibition of endopeptidase 24.11 in essential hypertension: evidence for enhanced atrial natriuretic peptide and angiotensin II.
MedLine Citation:
PMID:  8390508     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine the renal, endocrine and haemodynamic effects of an orally active inhibitor of the neutral endopeptidase EC 3.4.24.11 in essential hypertension. METHODS: Two groups of 12 white male patients with essential hypertension were treated with candoxatril at 25 mg every 12 h (group 1) or at 200 mg every 12 h (group 2) for 5 days in double-blind, placebo-controlled, crossover studies. RESULTS: Candoxatril enhanced natriuresis over the initial 48 h of treatment. Twenty-four-hour diurnal hormone profiles (day 4) showed modest elevations in plasma atrial natriuretic factor (ANF) concentrations and more clear-cut increases in plasma and urinary cyclic GMP. Plasma angiotensin II and aldosterone concentrations were also significantly increased. Plasma catecholamine concentrations were significantly increased by the higher dose of candoxatril. Blood pressure (day 4, 24-h intra-arterial recordings) fell significantly with both doses. The infusions of exogenous ANF and angiotensin II on day 5 showed that candoxatril impaired the metabolic clearance of both ANF and angiotensin II with consequent enhancement of the biological effects of both effector peptides. CONCLUSIONS: Candoxatril augments the effects of ANF and lowers blood pressure in patients with hypertension. However, the antihypertensive effects may be offset by increased angiotensin-aldosterone and sympathetic nervous system activity. The blood pressure response to endopeptidase inhibition in hypertensive patients may depend on the relative effects on humoral vasodilator (including ANF) and vasoconstrictor (including the angiotensin-aldosterone and sympathetic) systems.
Authors:
A M Richards; G A Wittert; I G Crozier; E A Espiner; T G Yandle; H Ikram; C Frampton
Related Documents :
3346058 - Total plasma dopamine/norepinephrine ratio in catecholamine-secreting tumors. its relat...
15854148 - The 'body fluid pressure control system' relies on the renin-angiotensin-aldosterone sy...
2972348 - Atrial natriuretic factor in the pediatric intensive care unit.
3908128 - Cardiovascular, baroreflex and humoral responses in hypertensive patients during nicard...
20409898 - Exaggerated exercise blood pressure response is related to tissue doppler imaging estim...
694688 - The prevalence of hypertension in the indian population of durban.
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  11     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-07-20     Completed Date:  1993-07-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  407-16     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Princess Margaret Hospital, Christchurch, New Zealand.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Angiotensin II / administration & dosage,  blood
Atrial Natriuretic Factor / administration & dosage,  blood
Blood Pressure / drug effects
Double-Blind Method
Heart Rate / drug effects
Humans
Hypertension / blood,  drug therapy*,  physiopathology
Indans / pharmacology*
Kidney / drug effects
Male
Middle Aged
Natriuresis / drug effects
Neprilysin / antagonists & inhibitors*
Propionates / pharmacology*
Time Factors
Chemical
Reg. No./Substance:
0/Indans; 0/Propionates; 11128-99-7/Angiotensin II; 118785-03-8/candoxatril; 85637-73-6/Atrial Natriuretic Factor; EC 3.4.24.11/Neprilysin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Ceranapril and cerebral blood flow autoregulation.
Next Document:  Evidence for altered platelet nitric oxide synthesis in essential hypertension.