RESUMO
25 elderly hypertensive patients (mean age 66.5 +/- 5.0 years) were given enalapril (E) 20-40 mg daily, or calcium channel blockers (CCB): either slow-release nifedipine (40 mg) or long-acting verapamil (120-360 mg) daily, 6 weeks each, in a single-blind crossover study. At the end of each treatment period cerebral blood flow (CBF) was assessed by single proton emission, computed tomography, using 99m-Tc-exametazime. In the 20 patients who completed the study, supine BP was lowered from 194/106 to 167/90 mmHg (p less than 0.001/0.001) by E and from 185/104 to 172/91 (p less than 0.01/0.001) by CCB. Standing BP was lowered from 184/106 to 160/93 (p less than 0.001/0.001) by E and from 175/102 to 162/93 (p less than 0.01/0.01) by CCB. Although there were great interpatient differences in CBF, the individual pattern remained unaltered by either E or CCB and mean quantitative changes were not significant. We conclude that in elderly hypertensives both E and CCB effectively lower BP, while cerebral perfusion is not adversely affected by either.
Assuntos
Bloqueadores dos Canais de Cálcio/uso terapêutico , Circulação Cerebrovascular/efeitos dos fármacos , Enalapril/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Idoso , Pressão Sanguínea/efeitos dos fármacos , Humanos , Pessoa de Meia-Idade , Método Simples-CegoAssuntos
Pressão Sanguínea/efeitos dos fármacos , Circulação Cerebrovascular/efeitos dos fármacos , Enalapril/uso terapêutico , Hipertensão/fisiopatologia , Nifedipino/uso terapêutico , Verapamil/uso terapêutico , Idoso , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Método Simples-CegoRESUMO
During the past few years, dry cough has been described as a possible adverse effect of treatment with angiotensin converting enzyme (ACE) inhibitors. There have been several studies of the effect of long-term administration of ACE inhibitors on pulmonary function. We examined spirometrically the effect of a single oral dose of captopril (25 mg) on bronchial tonus in those who had not received the drug previously, in 4 patients who had previously had dry cough during ACE inhibitor therapy, in 20 patients with obstructive pulmonary disease and in 20 control subjects without pulmonary disease. 1 hour after ingestion of captopril there were no significant changes in the spirometric tests of any group. These findings supplement the results of similar tests done during longterm administration of ACE inhibitors, indicating that the pathogenesis of cough elicited by ACE inhibitor therapy does not seem to have an asthmatic basis.
