RESUMEN
Antihypertensive drug therapies have demonstrated their capacity to modulate the inflammatory processes associated with hypertension, leading to improvements in disease progression. Given the prevalent use of polytherapy in treating most hypertensive patients, comprehending the time-dependent effects of combination treatments on inflammation becomes imperative. In this study, spontaneously hypertensive rats (SHR) were divided into seven groups (n = 6): (i) SHR + vehicle, (ii) SHR + nebivolol, (iii) SHR + valsartan, (iv) SHR + lisinopril, (v) SHR + nebivolol-valsartan, (vi) SHR + nebivolol-lisinopril, and (vii) WKY + vehicle. Blood pressure was measured using the tail-cuff method. Temporal alterations in inflammatory cytokines TNF-α, IL-6, and IL-10 were assessed in serum through ELISA and mRNA expression in aortic tissue via qPCR after 1, 2, and 4 weeks of treatment with nebivolol, lisinopril, valsartan, and their respective combinations. Histological alterations in the aorta were assessed. The findings indicated that combined treatments reduced systolic and diastolic blood pressure in SHR. The nebivolol and lisinopril combination demonstrated a significant decrease in IL-6 serum and mRNA expression at both 1 week and 4 weeks into the treatment. Additionally, TNF-α mRNA expression also showed a reduction with this combination at the same time points. Particularly, nebivolol-valsartan significantly decreased TNF-α serum and mRNA expression after one and four weeks of treatment. Furthermore, an elevation in serum IL-10 levels was observed with both combination treatments starting from the second week onwards. This study provides compelling evidence that concurrent administration of nebivolol with lisinopril or valsartan exerts time-dependent effects, reducing proinflammatory cytokines TNF-α and IL-6 while modifying IL-10 levels in an experimental hypertensive model.
Asunto(s)
Hipertensión , Lisinopril , Humanos , Ratas , Animales , Nebivolol/farmacología , Nebivolol/uso terapéutico , Ratas Endogámicas SHR , Lisinopril/farmacología , Lisinopril/uso terapéutico , Interleucina-6/genética , Factor de Necrosis Tumoral alfa/genética , Antihipertensivos/farmacología , Antihipertensivos/uso terapéutico , Interleucina-10/genética , Ratas Endogámicas WKY , Hipertensión/tratamiento farmacológico , Citocinas , Valsartán/uso terapéutico , ARN MensajeroRESUMEN
The widespread distribution of contaminants of emerging concern (CECs) is a major concern due to their potential effects on human health and the environment. The insufficient sewage treatment plant infrastructures is a global problem most accentuated in less developed countries and results in the discharge of CECs to water bodies. Pacu (Piaractus mesopotamicus) is a ray-finned freshwater fish species native to the Paraná basin. It is also the most produced aquaculture fish species in Argentina since 2012. Though uninvestigated to date, the occurrence of CECs in pacu may be of high relevance due to production volumes and relevance to human exposure through fish consumption. In this study, we applied a high-resolution mass spectrometry screening method to qualitatively analyze over 100 CECs in pacu. Four extraction/cleanup methods were tested on pooled pacu fillet, including solid-phase extraction and QuEChERS. The method that produced the highest number of detections was selected for further analysis of pacu purchased in supermarkets and fish markets in Argentina between 2017 and 2020. Residues of pesticides, antibiotics, pharmaceuticals, personal care products, plasticizers, sweeteners, drug metabolites, stimulants, and illegal drugs were detected in the samples. A total of 38 CECs were detected, ranging between 24 and 35 CECs per individual sample. 100% of the samples had positive detections of caffeine, 1,7-dimethylxanthine, xanthine, benzoylecgonine, methylparaben, ethylparaben, bis(2-ethylhexyl) phthalate (DEHP), metolachlor, carbendazim, salicylic acid, 2,4-D, saccharin, cyclamate, and dodecanedioic acid. Mappings generated with correspondence analysis were used to explore similarities/dissimilarities among the detected compounds. To our knowledge this is the first report of saccharin, cyclamate, 2,4 - D, carbendazim, metolachlor, ethylparaben, propylparben, bisphenol A, DEHP, and benzotriazole in fish from Argentina, and the first report on the presence of lisinopril, metropolol acid and dodecanedioic acid in fish worldwide.
Asunto(s)
Drogas Ilícitas , Plaguicidas , Contaminantes Químicos del Agua , Animales , Ácido 2,4-Diclorofenoxiacético , Antibacterianos/análisis , Argentina , Cafeína/análisis , Ciclamatos/análisis , Dietilhexil Ftalato , Monitoreo del Ambiente , Drogas Ilícitas/análisis , Lisinopril , Plaguicidas/análisis , Plastificantes/análisis , Sacarina/análisis , Ácido Salicílico/análisis , Aguas del Alcantarillado/análisis , Edulcorantes/análisis , Contaminantes Químicos del Agua/análisisRESUMEN
Clinical guidelines suggest the combination of 2 drugs as a strategy to treat hypertension. However, some antihypertensive combinations have been shown to be ineffective. Therefore, it is necessary to determine whether differences exist between the results of monotherapy and combination therapy by temporal monitoring of the responses to angiotensin II and norepinephrine, which are vasoconstrictors involved in the development of hypertension. Thus, the purpose of this work was to determine the vascular reactivity to angiotensin II and norepinephrine in spontaneously hypertensive rat (SHR) aortic rings after treatment with valsartan, lisinopril, nebivolol, nebivolol-lisinopril, and nebivolol-valsartan for different periods of time. In this study, male SHR and Wistar Kyoto normotensive (WKY) rats were divided into 7 groups treated for 1, 2, and 4 weeks: (1) WKY + vehicle, (2) SHR + vehicle; (3) SHR + nebivolol; (4) SHR + lisinopril; (5) SHR + valsartan; (6) SHR + nebivolol-lisinopril; and (7) SHR + nebivolol-valsartan. Blood pressure was measured by the tail-cuff method, and vascular reactivity was determined from the concentration-response curve to angiotensin II and norepinephrine in aortic rings. The results showed that the combined and individual treatments reduced mean blood pressure at all times evaluated. All treatments decreased vascular reactivity to angiotensin II; however, in the case of lisinopril and nebivolol-lisinopril, the effect observed was significant up to 2 weeks. All treatments decreased the reactivity to norepinephrine up to week 4. These results show a time-dependent difference in vascular reactivity between the pharmacological treatments, with nebivolol-valsartan and nebivolol-lisinopril being both effective combinations. Additionally, the results suggest crosstalk between the renin-angiotensin and sympathetic nervous systems to reduce blood pressure and to improve treatment efficacy.
Asunto(s)
Angiotensina II/farmacología , Antihipertensivos/farmacología , Presión Sanguínea/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Norepinefrina/farmacología , Vasoconstrictores/farmacología , Animales , Combinación de Medicamentos , Lisinopril/farmacología , Masculino , Nebivolol/farmacología , Ratas Endogámicas SHR , Ratas Wistar , Tiempo , Valsartán/farmacología , Resistencia Vascular/efectos de los fármacosRESUMEN
Schistosomiasis mansoni is involved in hepatic fibrogenesis and portal hypertension. Previous studies proved that blockade of some components of the renin-angiotensin system (RAS) reduce liver fibrogenesis. However, the effects of inhibition of early stages of RAS pathway in schistosomal fibrosis have not been studied yet. Thus, the aim of this study was to compare the role of different antihypertensive drugs on hepatic fibrosis in murine schistosomiasis. BALB/c mice (nâ¯=â¯50) weighing 20g were subjected to inoculation of 50 cercariae and submitted to different treatments: aliskiren, 50â¯mg/kg (nâ¯=â¯10); bradykinin, 2⯵g/kg (nâ¯=â¯5); losartan, 10â¯mg/kg (nâ¯=â¯10); lisinopril 10â¯mg/kg (nâ¯=â¯5) and control, proportional volume vehicle (nâ¯=â¯5); daily for 14 weeks. Six animals were not subjected to cercariae inoculation or any type of treatment. Ultrasound, histological, immunohistochemical and proteomic analyzes were performed to evaluate markers associated with hepatic fibrogenesis. The hepatic areas stained with Sirius red and thenumber of cells marked by α-SMA in animals treated with aliskiren, bradykinin, lisinopril and losartan were diminished when compared to control group, demonstrating reduced hepatic fibrosis after RAS blockade. These results were reinforced by ultrasonography analysis and protein expression of TGFß. These findings demonstrated the effect of RAS inhibition on hepatic fibrosis in murine schistosomiasis, with the most evident results being observed in the losartan and aliskiren treated groups. The main mechanisms underlying this process appear to involve anti-fibrogenic activity through the inhibition of collagen and TGFß synthesis.
Asunto(s)
Cirrosis Hepática/tratamiento farmacológico , Sistema Renina-Angiotensina/efectos de los fármacos , Esquistosomiasis mansoni/complicaciones , Amidas/farmacología , Amidas/uso terapéutico , Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Animales , Antihipertensivos/farmacología , Antihipertensivos/uso terapéutico , Bradiquinina/farmacología , Bradiquinina/uso terapéutico , Fumaratos/farmacología , Fumaratos/uso terapéutico , Lisinopril/farmacología , Lisinopril/uso terapéutico , Hígado/efectos de los fármacos , Hígado/patología , Cirrosis Hepática/parasitología , Losartán/farmacología , Losartán/uso terapéutico , Masculino , Ratones , Ratones Endogámicos BALB C , Óxido Nítrico Sintasa de Tipo III/efectos de los fármacos , Óxido Nítrico Sintasa de Tipo III/genética , Óxido Nítrico Sintasa de Tipo III/metabolismo , Proto-Oncogenes Mas , Proteínas Proto-Oncogénicas/efectos de los fármacos , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas/metabolismo , Receptores Acoplados a Proteínas G/efectos de los fármacos , Receptores Acoplados a Proteínas G/genética , Receptores Acoplados a Proteínas G/metabolismo , Renina/efectos de los fármacos , Renina/genética , Renina/metabolismo , Esquistosomiasis mansoni/tratamiento farmacológico , Esquistosomiasis mansoni/patología , Inhibidor Tisular de Metaloproteinasa-1/efectos de los fármacos , Inhibidor Tisular de Metaloproteinasa-1/genética , Inhibidor Tisular de Metaloproteinasa-1/metabolismo , Factor de Crecimiento Transformador beta1/efectos de los fármacos , Factor de Crecimiento Transformador beta1/genética , Factor de Crecimiento Transformador beta1/metabolismo , Vasodilatadores/farmacología , Vasodilatadores/uso terapéutico , Proteínas Quinasas p38 Activadas por Mitógenos/efectos de los fármacos , Proteínas Quinasas p38 Activadas por Mitógenos/genética , Proteínas Quinasas p38 Activadas por Mitógenos/metabolismoRESUMEN
Angiotensin converting enzyme (ACE) presents an important role in blood pressure regulation, since that converts angiotensin I to the vasoconstrictor angiotensin II. Some commercially available ACE inhibitors are captopril, lisinopril and enalapril; due to their side effects, naturally occurring inhibitors have been prospected. In order to endorse this research field we have developed a new tool for ACE ligand screening. To this end, ACE was extracted from bovine lung, purified and chemically immobilized in modified ferrite magnetic beads (ACE-MBs). The ACE-MBs have shown a Michaelian kinetic behavior towards hippuryl-histidyl-leucine. Moreover, as proof of concept, the ACE-MBs was inhibited by lisinopril with a half maximal inhibitory concentration (IC50) of 10nM. At the fishing assay, ACE-MBs were able not only to fish out the reference inhibitor, but also one peptide from a pool of tryptic digested BSA. In conclusion, ACE-MBs emerge as new straightforward tool for ACE kinetics determination, inhibition and binder screening.
Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/química , Enzimas Inmovilizadas/química , Peptidil-Dipeptidasa A/química , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Angiotensinas/química , Animales , Captopril/química , Bovinos , Cromatografía Liquida , Enalapril/química , Concentración 50 Inhibidora , Hierro/química , Cinética , Ligandos , Lisinopril/química , Pulmón/metabolismo , Nanopartículas de Magnetita/química , Reproducibilidad de los Resultados , Propiedades de Superficie , Espectrometría de Masas en Tándem , Tripsina/químicaRESUMEN
BACKGROUND: The angiotensin-I converting enzyme (ACE) plays a central role in the renin-angiotensin system, acting by converting the hormone angiotensin-I to the active peptide angiotensin-II (Ang-II). More recently, ACE was shown to act as a receptor for Ang-II, and its expression level was demonstrated to be higher in melanoma cells compared to their normal counterparts. However, the function that ACE plays as an Ang-II receptor in melanoma cells has not been defined yet. AIM: Therefore, our aim was to examine the role of ACE in tumor cell proliferation and migration. RESULTS: We found that upon binding to ACE, Ang-II internalizes with a faster onset compared to the binding of Ang-II to its classical AT1 receptor. We also found that the complex Ang-II/ACE translocates to the nucleus, through a clathrin-mediated process, triggering a transient nuclear Ca2+ signal. In silico studies revealed a possible interaction site between ACE and phospholipase C (PLC), and experimental results in CHO cells, demonstrated that the ß3 isoform of PLC is the one involved in the Ca2+ signals induced by Ang-II/ACE interaction. Further studies in melanoma cells (TM-5) showed that Ang-II induced cell proliferation through ACE activation, an event that could be inhibited either by ACE inhibitor (Lisinopril) or by the silencing of ACE. In addition, we found that stimulation of ACE by Ang-II caused the melanoma cells to migrate, at least in part due to decreased vinculin expression, a focal adhesion structural protein. CONCLUSION: ACE activation regulates melanoma cell proliferation and migration.
Asunto(s)
Angiotensina II/metabolismo , Núcleo Celular/metabolismo , Melanoma/enzimología , Peptidil-Dipeptidasa A/metabolismo , Fosfolipasa C beta/metabolismo , Vinculina/metabolismo , Animales , Células CHO , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Simulación por Computador , Cricetulus , Humanos , Lisinopril/farmacología , Melanoma/genética , Melanoma/metabolismo , Peptidil-Dipeptidasa A/genética , Transporte de ProteínasRESUMEN
The mechanism of hypertension-induced renal fibrosis is not well understood, although it is established that high levels of angiotensin II contribute to the effect. Since ß-catenin signal transduction participates in fibrotic processes, we evaluated the contribution of ß-catenin-dependent signaling pathway in hypertension-induced renal fibrosis. Two-kidney one-clip (2K1C) hypertensive rats were treated with lisinopril (10 mg/kg/day for four weeks) or with pyrvinium pamoate (Wnt signaling inhibitor, single dose of 60 ug/kg, every 3 days for 2 weeks). The treatment with lisinopril reduced the systolic blood pressure from 220 ± 4 in 2K1C rats to 112 ± 5 mmHg (P < 0.05), whereas the reduction in blood pressure with pyrvinium pamoate was not significant (212 ± 6 in 2K1C rats to 170 ± 3 mmHg, P > 0.05). The levels of collagen types I and III, osteopontin, and fibronectin decreased in the unclipped kidney in both treatments compared with 2K1C rats. The expressions of ß-catenin, p-Ser9-GSK-3beta, and the ß-catenin target genes cyclin D1, c-myc, and bcl-2 significantly decreased in unclipped kidney in both treatments (P < 0.05). In this study we provided evidence that ß-catenin-dependent signaling pathway participates in the renal fibrosis induced in 2K1C rats.
Asunto(s)
Fibrosis/genética , Hipertensión/genética , Enfermedades Renales/genética , beta Catenina/genética , Angiotensina II/genética , Animales , Presión Sanguínea/genética , Ciclina D1/metabolismo , Fibrosis/tratamiento farmacológico , Fibrosis/patología , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/patología , Riñón/efectos de los fármacos , Riñón/patología , Enfermedades Renales/tratamiento farmacológico , Enfermedades Renales/patología , Lisinopril/administración & dosificación , Proteínas Proto-Oncogénicas c-myc/metabolismo , Compuestos de Pirvinio/administración & dosificación , Ratas , Transducción de Señal/efectos de los fármacosRESUMEN
A simple and rapid stability-indicating liquid chromatographic method was developed and validated for the simultaneous determination of lisinopril and hydrochlorotiazide (HCTZ) in drug substances and dosage forms in the presence of degradation products. Forced degradation studies were conducted on the pure drugs under hydrolytic, oxidative, thermal and photolytic conditions. A chromatographic separation of the two drugs and its degradation products was achieved with an RP-18 column, using methanol, acetonitrile and phosphate buffer (pH 7.1; 0.05 M) (15:15:70, v/v/v) as mobile phase at a flow rate of 0.8 mL min(-1) and UV detection at 210 nm. Lisinopril and HCTZ were well resolved from its degradation products showing the stability-indicating capability of the method. The described method was linear over a range of 40-200 µg mL(-1) for lisinopril and 25-175 µg mL(-1) for HCTZ. The assay was also selective, accurate and precise for lisinopril and HCTZ determination. This method represents an alternative to the United States Pharmacopeia (USP) method showing shorter retention time. The method was successfully applied for determination of lisinopril and HCTZ in combined commercial tablets. The results showed that the proposed method was found to be suitable for quantitative determination and the stability study of lisinopril and HCTZ in pharmaceutical samples.
Asunto(s)
Cromatografía Liquida/métodos , Hidroclorotiazida/análisis , Hidroclorotiazida/química , Lisinopril/análisis , Lisinopril/química , Estabilidad de Medicamentos , Límite de Detección , Modelos Lineales , Reproducibilidad de los Resultados , Comprimidos/químicaRESUMEN
BACKGROUND AND OBJECTIVES: CKD is common among older patients. This article assesses long-term renal and cardiovascular outcomes in older high-risk hypertensive patients, stratified by baseline estimated GFR (eGFR), and long-term outcome efficacy of 5-year first-step treatment with amlodipine or lisinopril, each compared with chlorthalidone. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a long-term post-trial follow-up of hypertensive participants (n=31,350), aged ≥55 years, randomized to receive chlorthalidone, amlodipine, or lisinopril for 4-8 years at 593 centers. Participants were stratified by baseline eGFR (ml/min per 1.73 m(2)) as follows: normal/increased (≥90; n=8027), mild reduction (60-89; n=17,778), and moderate/severe reduction (<60; n=5545). Outcomes were cardiovascular mortality (primary outcome), total mortality, coronary heart disease, cardiovascular disease, stroke, heart failure, and ESRD. RESULTS: After an average 8.8-year follow-up, total mortality was significantly higher in participants with moderate/severe eGFR reduction compared with those with normal and mildly reduced eGFR (P<0.001). In participants with an eGFR <60, there was no significant difference in cardiovascular mortality between chlorthalidone and amlodipine (P=0.64), or chlorthalidone and lisinopril (P=0.56). Likewise, no significant differences were observed for total mortality, coronary heart disease, cardiovascular disease, stroke, or ESRD. CONCLUSIONS: CKD is associated with significantly higher long-term risk of cardiovascular events and mortality in older hypertensive patients. By eGFR stratum, 5-year treatment with amlodipine or lisinopril was not superior to chlorthalidone in preventing cardiovascular events, mortality, or ESRD during 9-year follow-up. Because data on proteinuria were not available, these findings may not be extrapolated to proteinuric CKD.
Asunto(s)
Amlodipino/uso terapéutico , Antihipertensivos/uso terapéutico , Clortalidona/uso terapéutico , Tasa de Filtración Glomerular , Hipertensión/tratamiento farmacológico , Hipolipemiantes/uso terapéutico , Enfermedades Renales/tratamiento farmacológico , Riñón/fisiopatología , Lisinopril/uso terapéutico , Infarto del Miocardio/prevención & control , Canadá , Enfermedad Crónica , Enfermedad Coronaria/etiología , Enfermedad Coronaria/mortalidad , Enfermedad Coronaria/prevención & control , Método Doble Ciego , Femenino , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/prevención & control , Humanos , Hipertensión/complicaciones , Hipertensión/mortalidad , Hipertensión/fisiopatología , Incidencia , Estimación de Kaplan-Meier , Enfermedades Renales/complicaciones , Enfermedades Renales/mortalidad , Enfermedades Renales/fisiopatología , Fallo Renal Crónico/etiología , Fallo Renal Crónico/mortalidad , Fallo Renal Crónico/prevención & control , Masculino , Persona de Mediana Edad , Análisis Multivariante , Infarto del Miocardio/etiología , Infarto del Miocardio/mortalidad , Infarto del Miocardio/fisiopatología , Modelos de Riesgos Proporcionales , Puerto Rico , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/prevención & control , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos , Islas Virgenes de los Estados UnidosRESUMEN
FUNDAMENTO: O efeito renoprotetor dos inibidores da ECA vem sendo questionado no caso de diminuição do volume circulante efetivo, como na insuficiência cardíaca crônica direita ou biventricular. Objetivo: Detectar os preditores clínicos de agravamento renal na população de pacientes com ICC, caracterizado por dois tipos de regime de dosagem de inibidores da ECA. MÉTODOS: De acordo com um desenho de coorte retrospectiva, seguimos dois grupos de pacientes com ICC - tanto direita quanto biventricular -, todos na classe III da NYHA, tratados com inibidores da ECA (enalapril ou lisinopril), e com fração de ejeção do ventrículo esquerdo (FEVE) < 50 por cento, por meio de distinção em sua dosagem de inibidor da ECA: média-baixa (< 10 mg por dia) ou dosagem "alta" (> 10 mg por dia) de enalapril ou lisinopril. A disfunção renal agravada (ARD) foi definida pelo aumento de Cr > 30 por cento com relação ao segmento basal. O modelo de risco proporcional de Cox foi utilizado para identificar os preditores da ARD entre as seguintes variáveis: os inibidores da ECA com "alta" dosagem, idade, FEVE basal, histórico de repetidas terapias intensivas com diuréticos de alça por via intravenosa (diurético intravenoso), diabete, Cr basal, histórico de hipertensão, pressão arterial sistólica < 100 mmHg. RESULTADOS: Cinquenta e sete pacientes foram recrutados, dos quais 15 foram tratados com inibidor da ECA com dosagem "alta". Durante um seguimento médio de 718 dias, a ARD ocorreu em 17 pacientes (29,8 por cento). Apenas o inibidor da ECA com "alta" dosagem (RR: 12,4681 IC: 2,1614 - 71,9239 p = 0,0050) e Cr basal (RR:1,2344 IC: 1,0414 - 1,4632 p = 0,0157) foi demonstrado ser preditor da ARD. Além disso, demonstrou-se que o inibidor da ECA com dosagens "altas" não previu ARD em ICC sem diurético intravenoso e ICC com diabete. CONCLUSÃO: Na ICC de classe III da NYHA, o inibidor da ECA com "altas" dosagens e um maior Cr basal foi preditor da ARD. A nefrotoxicidade relacionada com inibidores da ECA em "altas" dosagens foi aumentada com o diurético intravenoso, ao passo que, em pacientes com ICC com diabete, aquela não foi detectada.
BACKGROUND: Renoprotective effect of ACE-inhibitors has been questioned in case of decreased effective circulating volume, like in right or biventricular chronic heart failure. OBJECTIVE: To detect clinical predictors of renal worsening in CHF patient population characterized by two types of ACE-inhibitor dosing regimens. METHODS: According to a retrospective cohort design, we followed 2 groups of patients with CHF - whether right or biventricular -, all in III NYHA class treated with ACE-inhibitors (enalapril or lisinopril), and with left ventricular ejection fraction (LVEF) < 50 percent, by distinguishing them by ACE-inhibitor dosing: average-low (<10 mg per day) or "high" dose (>10 mg per day) of enalapril or lisinopril. Worsened renal failure (ARD) was defined by Cr increase >30 percent from baseline. Cox proportional hazards model was used to identify the predictors of ARD among the following variables: ACE-inhibitors "high" dose, age, basal LVEF, history of repeated intensive intravenous loop diuretic therapies (IV diur), diabetes, basal Cr, history of hypertension, systolic blood pressure < 100 mm Hg. RESULTS: 57 patients were recruited, of whom 15 were treated with ACE-inhibitor "high" dose. During a mean follow-up of 718 days, ARD occurred in 17 (29.8 percent) patients. Only ACE-inhibitor "high" dose (HR: 12.4681 C.I.: 2.1614-71.9239 p=0.0050) and basal Cr (HR: 1.2344 C.I.: 1.0414-1.4632 p=0.0157) were shown to predict ARD. Moreover, ACE-inhibitor "high" doses were shown to fail to predict ARD in both CHF without IV diur and CHF with diabetes. CONCLUSION: In III NYHA class CHF, ACE-inhibitor "high" doses and a higher basal Cr predicted ARD. Nephrotoxicity related to ACE-inhibitor "high" doses was increased by IV diur, whereas it was not detected in CHF patients with diabetes.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Creatinina/sangre , Diabetes Mellitus/tratamiento farmacológico , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Renal/inducido químicamente , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/sangre , Enfermedad Crónica , Quimioterapia Combinada , Diabetes Mellitus/sangre , Diuréticos/uso terapéutico , Métodos Epidemiológicos , Enalapril/administración & dosificación , Enalapril/efectos adversos , Enalapril/sangre , Lisinopril/administración & dosificación , Lisinopril/efectos adversos , Lisinopril/sangre , Valores de Referencia , Factores de Riesgo , Insuficiencia Renal/sangre , Insuficiencia Renal/prevención & controlRESUMEN
BACKGROUND: Renoprotective effect of ACE-inhibitors has been questioned in case of decreased effective circulating volume, like in right or biventricular chronic heart failure. OBJECTIVE: To detect clinical predictors of renal worsening in CHF patient population characterized by two types of ACE-inhibitor dosing regimens. METHODS: According to a retrospective cohort design, we followed 2 groups of patients with CHF - whether right or biventricular -, all in III NYHA class treated with ACE-inhibitors (enalapril or lisinopril), and with left ventricular ejection fraction (LVEF) < 50%, by distinguishing them by ACE-inhibitor dosing: average-low (<10 mg per day) or "high" dose (>10 mg per day) of enalapril or lisinopril. Worsened renal failure (ARD) was defined by Cr increase >30% from baseline. Cox proportional hazards model was used to identify the predictors of ARD among the following variables: ACE-inhibitors "high" dose, age, basal LVEF, history of repeated intensive intravenous loop diuretic therapies (IV diur), diabetes, basal Cr, history of hypertension, systolic blood pressure < 100 mm Hg. RESULTS: 57 patients were recruited, of whom 15 were treated with ACE-inhibitor "high" dose. During a mean follow-up of 718 days, ARD occurred in 17 (29.8%) patients. Only ACE-inhibitor "high" dose (HR: 12.4681 C.I.: 2.1614-71.9239 p=0.0050) and basal Cr (HR: 1.2344 C.I.: 1.0414-1.4632 p=0.0157) were shown to predict ARD. Moreover, ACE-inhibitor "high" doses were shown to fail to predict ARD in both CHF without IV diur and CHF with diabetes. CONCLUSION: In III NYHA class CHF, ACE-inhibitor "high" doses and a higher basal Cr predicted ARD. Nephrotoxicity related to ACE-inhibitor "high" doses was increased by IV diur, whereas it was not detected in CHF patients with diabetes.
Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Creatinina/sangre , Diabetes Mellitus/tratamiento farmacológico , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Renal/inducido químicamente , Anciano , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/sangre , Enfermedad Crónica , Diabetes Mellitus/sangre , Diuréticos/uso terapéutico , Quimioterapia Combinada , Enalapril/administración & dosificación , Enalapril/efectos adversos , Enalapril/sangre , Métodos Epidemiológicos , Femenino , Humanos , Lisinopril/administración & dosificación , Lisinopril/efectos adversos , Lisinopril/sangre , Masculino , Valores de Referencia , Insuficiencia Renal/sangre , Insuficiencia Renal/prevención & control , Factores de RiesgoRESUMEN
Angiotensin (Ang) I-converting enzyme (ACE) is involved in the control of blood pressure by catalyzing the conversion of Ang I into the vasoconstrictor Ang II and degrading the vasodilator peptide bradykinin. Human ACE also functions as a signal transduction molecule, and the binding of ACE substrates or its inhibitors initiates a series of events. In this study, we examined whether Ang II could bind to ACE generating calcium signaling. Chinese hamster ovary cells transfected with an ACE expression vector reveal that Ang II is able to bind with high affinity to ACE in the absence of the Ang II type 1 and type 2 receptors and to activate intracellular signaling pathways, such as inositol 1,4,5-trisphosphate and calcium. These effects could be blocked by the ACE inhibitor, lisinopril. Calcium mobilization was specific for Ang II, because other ACE substrates or products, namely Ang 1-7, bradykinin, bradykinin 1-5, and N-acetyl-seryl-aspartyl-lysyl-proline, did not trigger this signaling pathway. Moreover, in Tm5, a mouse melanoma cell line endogenously expressing ACE but not Ang II type 1 or type 2 receptors, Ang II increased intracellular calcium and reactive oxygen species. In conclusion, we describe for the first time that Ang II can interact with ACE and evoke calcium and other signaling molecules in cells expressing only ACE. These findings uncover a new mechanism of Ang II action and have implications for the understanding of the renin-Ang system.
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Angiotensina II/metabolismo , Señalización del Calcio/fisiología , Peptidil-Dipeptidasa A/metabolismo , Análisis de Varianza , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Animales , Células CHO , Señalización del Calcio/efectos de los fármacos , Células Cultivadas , Cricetinae , Cricetulus , Citometría de Flujo , Lisinopril/farmacología , Ratones , Especies Reactivas de Oxígeno/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
PURPOSE: To investigate the effect of ACE inhibitor, lisinopril and AT1 blocker, losartan, on the obstructive pancreatitis in rat. METHODS: Acute pancreatitis in rats (n=21) was induced for a common hepatic duct were ligated proximal to its entry into the pancreas and the common bile - pancreatic duct were also ligated near its junction with the duodenum, under ether anesthesia, after which the abdomen were closed. The animals was divided in tree groups, being two treated and control group. The animals was treated with Losartan and Lisinopril at the dose of 10µg/Kg body weight per day, i.p., in a proportional volume, for five days, before and after treatement. RESULTS: The inflammation, collagen deposition in the pancreas of treated animals were smaller, suggesting that the use of antihypertensive agents interfered positively in the depletion of the injury of the pancreas. Scythe showed a correlation between activity of pancreatic stellate cells (PSCs) lower in treated animals when compared to control. CONCLUSION: The pancreatic stellate cells strength are involved in collagen production during acute pancreatitis and why antihypertensive drugs such as lisinopril and losartan may possibly have beneficial effects in reducing pancreatic fibrosis in models of experimental obstructive pancreatitis.
OBJETIVO: Investigar o efeito de um inibidor da ECA, lisinopril e bloqueador AT1, losartan, a pancreatite obstrutiva em ratos. MÉTODOS: Pancreatite aguda em ratos (n = 21) foi induzida por um ducto hepático comum foram ligados proximal à sua entrada no pâncreas e da bílis comum - ducto pancreático também foram ligados perto de sua junção com o duodeno, sob anestesia com éter, após o que abdome foram fechadas. Os animais foram divididos em três grupos, sendo dois tratados eo grupo controle. Os animais foram tratados com lisinopril e losartan na dose de 10µg/Kg de peso corporal por dia, IP, em um volume proporcional, por cinco dias, antes e depois do tratamento com. RESULTADOS: A inflamação, deposição de colágeno no pâncreas de animais tratados foram menores, sugerindo que o uso de agentes anti-hipertensivos interferiram positivamente na diminuição da lesão do pâncreas. Este estudo mostrou uma correlação entre a atividade das células pancreáticas estreladas (CSP) menor nos animais tratados quando comparados ao control. CONCLUSÃO: A força das células pancreáticas estreladas está envolvida na produção de colágeno durante a pancreatite aguda e por medicamentos anti-hipertensivos, tais como lisinopril e losartan pode eventualmente ter efeitos benéficos na redução da fibrose do pâncreas em modelos experimentais de pancreatite obstrutiva.
Asunto(s)
Animales , Masculino , Ratas , Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Antihipertensivos/farmacología , Lisinopril/farmacología , Losartán/farmacología , Pancreatitis/tratamiento farmacológico , Colágeno/metabolismo , Modelos Animales de Enfermedad , Células Estrelladas Pancreáticas/efectos de los fármacos , Células Estrelladas Pancreáticas/metabolismo , Células Estrelladas Pancreáticas/patología , Pancreatitis/metabolismo , Pancreatitis/patología , Distribución Aleatoria , Ratas WistarRESUMEN
PURPOSE: To investigate the effect of ACE inhibitor, lisinopril and AT1 blocker, losartan, on the obstructive pancreatitis in rat. METHODS: Acute pancreatitis in rats (n=21) was induced for a common hepatic duct were ligated proximal to its entry into the pancreas and the common bile - pancreatic duct were also ligated near its junction with the duodenum, under ether anesthesia, after which the abdomen were closed. The animals was divided in tree groups, being two treated and control group. The animals was treated with Losartan and Lisinopril at the dose of 10µg/Kg body weight per day, i.p., in a proportional volume, for five days, before and after treatment. RESULTS: The inflammation, collagen deposition in the pancreas of treated animals were smaller, suggesting that the use of antihypertensive agents interfered positively in the depletion of the injury of the pancreas. Scythe showed a correlation between activity of pancreatic stellate cells (PSCs) lower in treated animals when compared to control. CONCLUSION: The pancreatic stellate cells strength are involved in collagen production during acute pancreatitis and why antihypertensive drugs such as lisinopril and losartan may possibly have beneficial effects in reducing pancreatic fibrosis in models of experimental obstructive pancreatitis.
Asunto(s)
Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Antihipertensivos/farmacología , Lisinopril/farmacología , Losartán/farmacología , Pancreatitis/tratamiento farmacológico , Animales , Colágeno/metabolismo , Modelos Animales de Enfermedad , Masculino , Células Estrelladas Pancreáticas/efectos de los fármacos , Células Estrelladas Pancreáticas/metabolismo , Células Estrelladas Pancreáticas/patología , Pancreatitis/metabolismo , Pancreatitis/patología , Distribución Aleatoria , Ratas , Ratas WistarRESUMEN
BACKGROUND: To investigate the effect of lisinopril on cardiac remodeling induced by smoking. MATERIAL/METHODS: Rats were allocated into 3 groups: group CON (n=8): control; group CSE (n=8): cigarette smoke exposure; group CSE-LIS (n=8): exposed to tobacco smoke and treated with lisinopril. RESULTS: After 2 months, the tail systolic pressure was lower in CSE-LIS (CON=116 +/-27 mm Hg, CSE=126+/-16, CSE-LIS=89+/-12; P<.001). CSE animals showed higher left ventricular systolic diameter (CON=8.25+/-2.16 mm/kg, CSE=11.5+/-1.3, CSE-LIS=9.27+/-2.00; P=.009) and myocyte cross-sectional area (CON=245+/-8 microm2, CSE=260+/-17, CSE-LIS=238+/-12; P=.01) than CON and CSE-LIS. The ejection fraction (CON =0.91+/-0.02, CSE=0.86+/-0.02, CSE-LIS=0.92+/-0.03; P=.002) and fractional shortening (CON=55.7+/-4.41%, CSE=48.7+/-3.43, CSE-LI=58.2+/-7.63; P=.006) were lower in CSE group than CON and CSE-LIS. CSE and CSE-LIS animals showed higher collagen amounts (CON=3.49+/-0.95%, CSE= 5.01+/-1.58, CSE-LIS=5.27+/-0.62; P=.009) than CON. CON group showed a higher connexin 43 amount in the intercalated disc (CON=3.70+/-0.38, CSE=2.13+/-0.53; CSE-LIS=2.17+/-0.73; P=.004) than CSE and CSE-LIS. There were no differences in IFN-gamma or TNF-alpha cardiac levels among the groups. CONCLUSIONS: Lisinopril attenuated both morphologic and functional abnormalities induced by exposure to tobacco smoke. In addition, this effect was associated with diminished blood pressure, but not alterations in connexin 43 distribution, cytokine production or collagen amount.
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Lisinopril/farmacología , Contaminación por Humo de Tabaco/efectos adversos , Remodelación Ventricular/efectos de los fármacos , Animales , Ecocardiografía , Masculino , Ratas , Ratas WistarRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: Salvia elegans Vahl. (Lamiaceae), recognized with the popular name of "mirto" is widely used in Mexico for healing purposes, and also them as antihypertensive treatment. AIM OF THE STUDY: The high prevalence of this illness and the side effects of antihypertensive drugs conducted us to the evaluation of the Salvia elegans extract on angiotensin II action. MATERIALS AND METHODS: The acute response of blood pressure to angiotensin II administration was measured in mice. We also tested in vitro the inhibitory effect on angiotensin convertase enzyme. Additionally, characterization of the pharmacological effect of the extract fraction was obtained. RESULTS: We obtained dose-response curve for the administration of complete extract and extract fractions. Due to the hydroalcoholic extract (SeHA) treatment blood pressure decreased significantly from systolic dose of 0.75 mg kg(-1) (p<0.05) and even had an antihypertensive effect that was greater than that treatment with losartan. SeHA extract decreased the E(max) of the AG II hypertensive effect by about 20% in both systolic and diastolic pressures, treatment with losartan also decreased the same parameter between 6% and 8% for systolic and diastolic pressures, respectively. Fractions SeF8 and SeF8-8 showed similar levels of AG II ED(50) for both pressures compared with losartan, these fractions showed major compounds with maximum absorbance peaks at 221, 289 and 330 nm typical of flavonoids. In the inhibition assay the activity of angiotensin converting enzyme (ACE), the extract SeHA showed percentage inhibition (%IACE) of 50.27+/-5.09% (n=5). SeBuOH fraction is found to have greater inhibitory capacity of achieving a IACE 78.40+/-2.24% (n=5), which was similar to the values obtained in the presence of the SeF8-22 fraction (82.61+/-1.74%) and lisinopril (87.18+/-1.16%). The changes in the value of K(M) suggest that components of the extracts and fractions were recognized by the enzyme's active site. The main compounds of the fractions SeBuOH, SeF8-22 were by flavonoid and phenyl propanoid types, according to UV absorption spectra of the fractions. CONCLUSIONS: The experimental results demonstrated the antihypertensive effect of Salvia elegans and it was due to the AG II antagonism and inhibition of angiotensin converting enzyme.
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Angiotensina II/antagonistas & inhibidores , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Antihipertensivos/farmacología , Presión Sanguínea/efectos de los fármacos , Hipertensión/prevención & control , Extractos Vegetales/farmacología , Salvia , Angiotensina II/administración & dosificación , Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Animales , Cromatografía en Capa Delgada , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Hipertensión/inducido químicamente , Hipertensión/fisiopatología , Inyecciones Intravenosas , Cinética , Lisinopril/farmacología , Losartán/farmacología , Ratones , Ratones Endogámicos ICR , Peptidil-Dipeptidasa A/metabolismo , Componentes Aéreos de las Plantas , Extractos Vegetales/química , Espectrofotometría UltravioletaRESUMEN
Collapsing glomerulopathy is a form of focal segmental glomerulosclerosis that is usually associated with HIV-1 infection, and is characterized by its poor prognosis and almost inevitable progression to end-stage renal disease. Its pathological features include collapsed glomeruli, podocyte hypertrophy and hyperplasia, and pseudocrescents. This case report shows the evolution of a 58-year-old patient with non-HIV idiopathic collapsing glomerulopathy who presented with severe nephrotic syndrome and renal insufficiency and was treated with lisinopril and deflazacort, a synthetic corticosteroid that has shown fewer cosmetic effects and glucose and bone metabolism complications than prednisone. The patient responded with full recovery of renal function and normal range of protein excreted in urine after less than two years of treatment. The patient has not suffered a recurrence of his nephrotic syndrome after three years of steroid withdrawal. There is no proven therapy for collapsing glomerulopathy, and this case highlights an alternative for treating this disease with few secondary effects.
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Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antiinflamatorios/uso terapéutico , Glomerulonefritis/tratamiento farmacológico , Lisinopril/uso terapéutico , Pregnenodionas/uso terapéutico , Biopsia , Quimioterapia Combinada , Glomerulonefritis/complicaciones , Glomerulonefritis/patología , Humanos , Riñón/efectos de los fármacos , Riñón/patología , Masculino , Persona de Mediana Edad , Síndrome Nefrótico/tratamiento farmacológico , Síndrome Nefrótico/etiología , Insuficiencia Renal/tratamiento farmacológico , Insuficiencia Renal/etiología , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
JUSTIFICATIVA E OBJETIVOS: O presente estudo teve como objetivo estudar a influência do lisinopril e do losartan na função endotelial em ratos com infarto experimental do miocárdio. MÉTODO: Ratos Wistar machos, peso entre 350 e 400 g, divididos em quatro grupos (n igual 10): G1 igual ratos controle sem infarto, G2 igual ratos com infarto, G3 igual ratos com infarto e tratados com lisinopril (20 mg/kg/dia) e G4 igual ratos com infarto e tratados com losartan (30 mg/kg/dia). Os fármacos foram administrados via gavagem dois dias antes do infarto e continuado por mais sete dias. Os ratos foram anestesiados com éter para a ligadura da coronária descendente anterior. Após nove dias os animais foram anestesiados, o coração excisado e verificado a extensão do infarto. Utilizou-se para este fim a coloração pelo método do cloreto de trifeniltetrazólio a 1%, se considerando infarto grande quando excedia 40% da área do ventrículo esquerdo. A função endotelial foi verificada através de curva de concentração efeito com acetilcolina em segmento proximal da aorta torácica. Foram utilizados os testes estatísticos de ANOVA e de Duncan, sendo considerado significativo o valor de p menor que 0,05. RESULTADOS: Os resultados obtidos para a função endotelial para o relaxamento máximo foram: G 1 igual 78,24% mais ou menos 3,57%; G2 igual 14,04% mais ou menos 5,20%, G3 igual 48,94% mais ou menos 9,29% e G4 igual 26,98% mais ou menos 7,80%. Houve diferença estatístíca significatíva para entre os G3 e G4. CONCLUSÃO: Ocorreu disfunção endotelial em ratos na fase recente do infarto do miocárdio e o tratamento com lisinopril e losartan melhoraram esta disfunção endotelial.
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Animales , Masculino , Ratas , Lisinopril/efectos adversos , Lisinopril/uso terapéutico , Losartán/efectos adversos , Losartán/uso terapéutico , Infarto del MiocardioRESUMEN
Introducción: El trasplante renal es el tratamiento de elección para los pacientes en insuficiencia renal terminal. A pesar que la nefrectomía clásica del donante vivo ha resultado ser un procedimiento seguro y bien tolerado, existen factores que desincentivan este acto de donación. La nefrectomía laparoscópica del donante vivo ha dado una respuesta a este último punto. Sin embargo, varios investigadores han comunicado mayor disfunción renal precoz en riñones procurados laparoscópicamente en comparación con los procurados en forma clásica abierta. Existe información que la Nacetilcisteina y Valsartán tendrían un efecto protector frente al neumoperitoneo. Con respecto al Lisinopril (inhibidor ECA) existen datos disímiles. El objetivo de este trabajo es evaluar la utilidad dela N-acetilcisteína, Valsartán y Lisinopril en la prevención de la disfunción renal precoz de riñones sometidos a neumoperitoneo en un modelo en ratas. Material y métodos: Se utilizaron 40 ratas Sprague Dawley, macho, de 250 a 300 g, separadas en 4 grupos: Grupo 1: 10 ratas sometidas a hidratación subcutánea con solución salina (control), Grupo 2: 10 ratas sometidas a hidratación subcutánea con solución salina más N-acetilcisteina, Grupo 3: 10ratas sometidas a hidratación subcutánea con solución salina más Valsartán, y Grupo 4: 10 ratas sometidas a hidratación subcutánea con solución salina más Lisinopril. Las ratas fueron anestesiadas y colocadas en neumoperitoneo a 12 mmHg por 90 minutos. Luego las ratas se colocaron en jaula metabólica donde se midió diuresis, presión arterial, función renal, microalbuminuria y enzimas tubulares. Las ratas fueron sacrificadas al séptimo día realizándose estudio histológico. En el análisis estadístico se utilizaron modelos lineales generalizados, análisis de la varianza (Anova) y test exacto de Fisher y Chi-cuadrado...
Introduction: Renal transplant it the treatment of choice for patients with terminal renal insufficiency. Classic open live donor nephrectomy is a safe and well tolerated procedure, however there some factors that may inhibit patients from donating. Laparoscopic live donor nephrectomy has gained wide acceptance, nevertheless several authors have reported early renal insufficiency in these patients compared to those harvested through the classic approach. Apparently n-acetylcysteine and valsartan would have a protective effect against pneumoperitoneum, however there is contradicting data for Lisinopril. We evaluate n-acetylcysteine, valsartan and lisinopril for prevention of early renal insufficiencyin kidneys undergoing pneumoperitoneum in a rat model. Material and methods: A total of 40 male rats (Sprague Dawley) of 250 and 300 grams were divided in4 groups. Group 1 (control): 10 rats with subcutaneous hydration with saline. Group 2: 10 rats with subcutaneous hydration with saline and n-acetylcysteine. Group 3: 10 rats with subcutaneous hydration with saline and Valsartan and Group 4: 10 rats with subcutaneous hydration with saline and Valsartan. All rats underwent general anesthesia with pneumoperitoneum at 12 mmHg for 90 minutes. Rats were placed in a metabolic cage where urine output, blood pressure, renal function, microalbuminuria and tubular enzymes were measured. At postoperative day seven, all animals were put to sleep and histological analysis was performed. Statistics was done using lineal generalized models, Anova, Fisher and Chi-square models were also used. Results: Pneumoperitoneum did not produce early renal insufficiency. Rats with lisinopril presented a decrease in creatinine clearance (0,92 ml/min) p=0,056; higher microalbuminuria (27073,9 mg/dl/creatininuria) p < 0,001 and more histological lesions p=0,017. Urine output, blood pressure, tubular...
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Animales , Ratas , Acetilcisteína/uso terapéutico , Insuficiencia Renal/prevención & control , Lisinopril/uso terapéutico , Neumoperitoneo Artificial , Tetrazoles/uso terapéutico , Modelos Animales de Enfermedad , Ratas Sprague-Dawley , Trasplante de Riñón , Valina/análogos & derivadosRESUMEN
Historically, blood pressure control in Hispanics has been considerably less than that of non-Hispanic whites and blacks. We compared determinants of blood pressure control among Hispanic white, Hispanic black, non-Hispanic white, and non-Hispanic black participants (N=32 642) during follow-up in a randomized, practice-based, active-controlled trial. Hispanic blacks and whites represented 3% and 16% of the cohort, respectively; 33% were non-Hispanic black and 48% were non-Hispanic white. Hispanics were less likely to be controlled (<140/90 mm Hg) at enrollment, but within 6 to 12 months of follow-up, Hispanics had a greater proportion <140/90 mm Hg compared with non-Hispanics. At 4 years of follow-up, blood pressure was controlled in 72% of Hispanic whites, 69% of Hispanic blacks, 67% of non-Hispanic whites, and 59% of non-Hispanic blacks. Compared with non-Hispanic whites, Hispanic whites had a 20% greater odds of achieving BP control by 2 years of follow-up (odds ratio: 1.20; 95% CI: 1.10 to 1.31) after controlling for demographic variables and comorbidities, Hispanic blacks had a similar odds of achieving BP control (odds ratio: 1.04; 95% CI: 0.86 to 1.25), and non-Hispanic blacks had a 27% lower odds (odds ratio: 0.73; 95% CI: 0.69 to 0.78). We conclude that in all patients high levels of blood pressure control can be achieved with commonly available medications and that Hispanic ethnicity is not associated with inferior control in the setting of a clinical trial in which hypertensive patients had equal access to medical care, and medication was provided at no cost.