ABSTRACT
Telmisartan and angiotensin-converting enzyme inhibitors (ACEIs) are both effective and widely used antihypertensive drugs targeting renin-angiotensin-aldosterone system. The study aimed to estimate the efficacy and tolerability of telmisartan in comparison with different ACEIs as monotherapy in the treatment of hypertension. Cochrane Central Register of Controlled Trials, PubMed and Embase were searched for relevant studies. A meta-analysis of all randomized controlled trials fulfilling the predefined criteria was performed. A random-effect model was used to account for heterogeneity among trials. Twenty-eight randomized controlled trials involving 5157 patients were ultimately identified out of 721 studies. Telmisartan had a greater diastolic blood pressure (DBP) reduction than enalapril (weighted mean difference (WMD) 1.82, 95% confidence interval (CI) 0.66-2.99), ramipril (WMD 3.09, 95% CI 1.94-4.25) and perindopril (WMD 1.48, 95% CI 0.33-2.62). Telmisartan also showed a greater DBP response rate than enalapril (relative risk (RR) 1.15, 95% CI 1.05-1.26), ramipril (RR 1.34, 95% CI 1.11-1.61) and perindopril (RR 1.22, 95% CI 1.05-1.41). There was no statistical difference in DBP reduction or therapeutic response rate between telmisartan and lisinopril (WMD -0.30, 95% CI -0.65 to 0.05; RR 0.99, 95% CI 0.80-1.23, respectively). Telmisartan had fewer drug-related adverse events than enalapril (RR 0.57, 95% CI 0.44-0.74), ramipril (RR 0.44, 95% CI 0.26-0.75), lisinopril (RR 0.70, 95% CI 0.56-0.89) and perindopril (RR 0.52, 95% CI 0.28-0.98). The meta-analysis indicates that telmisartan provides a superior BP control to ACEIs (enalapril, ramipril and perindopril) and has fewer drug-related adverse events and better tolerability in hypertensive patients.
Subject(s)
Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Benzimidazoles/therapeutic use , Benzoates/therapeutic use , Hypertension/drug therapy , Enalapril/therapeutic use , Humans , Lisinopril/therapeutic use , Models, Statistical , Perindopril/therapeutic use , Ramipril/therapeutic use , Randomized Controlled Trials as Topic , Telmisartan , Treatment OutcomeSubject(s)
Amino Acids/blood , Antimalarials/pharmacology , Malaria/parasitology , Peptide Hydrolases/metabolism , Plasmodium berghei/enzymology , Animals , Antineoplastic Agents, Phytogenic/pharmacology , Camptothecin/analogs & derivatives , Camptothecin/pharmacology , Erythrocytes/analysis , Globins , MiceABSTRACT
Using preparative HPLC, Sephadex G-25 and analytic HPLC, we obtained an active peak inhibiting (3H) PCP receptor binding, with a molecular weight of 3,000 daltons. Another isolation process included acetic acid extraction, Toyopearl HW gel filtration, Sephadex G-10 chromatography and analytic HPLC. An active peak was also observed, which was consistent with that from the first isolation process.
Subject(s)
Brain/metabolism , Receptors, Neurotransmitter/metabolism , Receptors, Opioid/metabolism , Humans , Ligands , Molecular Weight , Receptors, Phencyclidine , Tissue Extracts/metabolismABSTRACT
Two biologically active peptides designated SCP-1 and SCP-2 have been isolated and partially characterized from porcine spinal cord. The results of amino acid analysis, electrophoresis, isoelectric focusing and the chromatographic analysis of the dansylated derivatives indicate that these two peptides are homogeneous. The amino acid composition and apparent untriakontapeptide and SCP-2 is a pentacospeptide. The N-terminal amino acids of SCP-1 and SCP-2 are Arginine and Tryptophan respectively. SCP-1 can stimulate the contraction of isolated guinea pig ileum and SCP-2 induces hypotension in anesthetized rat. Both SCP-1 and SCP-2 show no morphine-like activity. The chemical composition and biological properties of SCP-1 and SCP-2 distinguish them from any known peptide.
