| Chronic inhibition of endopeptidase 24.11 in essential hypertension: evidence for enhanced atrial natriuretic peptide and angiotensin II. | |
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MedLine Citation:
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PMID: 8390508 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A M Richards; G A Wittert; I G Crozier; E A Espiner; T G Yandle; H Ikram; C Frampton |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 11 ISSN: 0263-6352 ISO Abbreviation: J. Hypertens. Publication Date: 1993 Apr |
Date Detail:
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Created Date: 1993-07-20 Completed Date: 1993-07-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 407-16 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Princess Margaret Hospital, Christchurch, New Zealand. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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 |
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