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Antihypertensive treatment with cilazapril. Resting and exercise blood pressure, hormones and enzymes
K Breithaupt1, G G Belz, D G Spielmanns
1Center for Cardiovascular Pharmacology ZeKaPha GmbHa, Mainz-Wiesbaden, Federal Republic of Germany.
Insights
Long-term treatment with the angiotensin-converting enzyme (ACE) inhibitor cilazapril effectively lowers blood pressure in hypertensive patients. Cilazapril demonstrated sustained efficacy in reducing both resting and exercise blood pressure over an extended period.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension management requires effective long-term therapeutic strategies.
- Angiotensin-converting enzyme (ACE) inhibitors are a key class of antihypertensive medications.
Purpose of the Study:
- To evaluate the long-term effects of cilazapril on blood pressure (BP) and hormonal/enzyme activities in hypertensive patients.
- To assess the sustained antihypertensive efficacy of cilazapril during rest and exercise.
Main Methods:
- A longitudinal study involving 13 hypertensive patients over more than one year.
- Treatment phases included initial placebo, long-term cilazapril, a second placebo wash-out, and dose titration.
- Blood pressure was measured at rest and during isometric (handgrip) and isotonic (bicycle) exercise.
- Hormonal and enzyme activities were assessed post-dose.
Main Results:
- Long-term cilazapril treatment (mean 78 weeks) significantly reduced mean sitting BP from 151/101 mmHg to 137/91 mmHg.
- Subsequent placebo wash-out showed a slight increase in BP, which was again reduced upon re-initiation of cilazapril.
- Exercise BP during both isotonic and isometric tests was also favorably affected by cilazapril treatment.
Conclusions:
- Cilazapril demonstrates sustained efficacy in lowering blood pressure in hypertensive patients over extended treatment durations.
- The drug is effective in reducing both resting and exercise-induced blood pressure elevations.
- Hormonal and enzyme activity changes warrant further investigation in relation to long-term cilazapril use.
Abstract:
The effects of the angiotensin-converting enzyme (ACE) inhibitor cilazapril (Ro 31-2848) on resting and exercise blood pressure (BP) as well as on hormonal and enzyme activities were evaluated following a more than one year long-term treatment. After an initial placebo wash-out (mean sitting BP 151/101), n = 13 hypertensive patients were on cilazapril treatment (1.25, 2.5 or 5 mg/d; in 2 cases with 25 mg hydrochlorothiazide additionally) for 78 (70 to 82) weeks (phase A, mean sitting BP 137/91). Thereafter, they underwent a second placebo wash-out of 4.4 (1 to 10) weeks (phase B, mean sitting BP 137/94) again followed by cilazapril treatment of 9.5 (4 to 14) weeks (phase C, mean sitting BP 137/91) to titrate the minimum antihypertensive dose. At the end of each phase, blood pressure was measured at rest and during isotonic (bicycle) and isometric (handgrip) exercise, and hormones and enzymes were evaluated 4 h post-dose.