Losartan vs Captopril
ironjustice
"Losartan vs Captopril"
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Blockade of angiotensin II AT 1 receptor reduces hematocrit in
patients with posttransplant erythrocytosis.
Transplant Proc. 1998; 30(7):3072-3 (ISSN: 0041-1345)
Tsang WK; Tong KL; Chan HW
Department of Medicine, Princess Margaret Hospital, Hong Kong, China.
PreMedline Identifier: 9838354
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Since ACE inhibitors are iron binders .. would they not then be
just .. glorified
bloodletting ..?
"Are iron chelators specially enalapril"
[Angiotensin-converting enzyme inhibitors as neutralizers of hydroxyl
radical]
Rev Port Cardiol. 1992 May;11(5):425-30.
Mira ML, Silva MM, Queiros MJ, Manso C.
Instituto de Quimica Fisiologica. Faculdade de Medicina de Lisboa.
Angiotensin converting enzyme inhibitors are utilized in the treatment
of
essential hypertension and of chronic cardiac failure. They are also
employed
in the treatment of the myocardial lesion of ischemia-reperfusion,
which
involves oxygen free radicals. In the present study we investigated
the
possibility of three angiotensin converting enzyme inhibitors
(captopril,
enalapril, lisinopril) to act as hydroxyl radical scavengers. The
rate
constants for reactions of those compounds with .OH were determined
using the
deoxyribose method. All three compounds proved to be good scavengers
of .OH
with rate constants of about 10(10)M-1s-1 and are iron chelators
specially
enalapril. The fact that captopril possesses a thiol group does not
confer an
higher antioxidative capacity. These results suggest that scavenging
of oxygen
free radicals may be a possible mechanism contributing to the
therapeutic
effect of angiotensin converting enzyme inhibitors.
PMID: 1325814
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http://www.medscape.com/viewarticle/406163_1
Tolerability and Antihypertensive Efficacy of Losartan vs Captopril in
Patients with Mild to Moderate Hypertension and Impaired Renal
Function: A Randomised, Double-Blind, Parallel Study
from Clinical Drug Investigation [TM]
Posted 03/01/2000
Egbert Schulz, Jasper Bech, E.B. Pedersen, Rodolfo Zavala, Mauricio
Ruiz, Gerhard Anton Müller for the Study Group, Department of
Nephrology/Rheumatology, Centre of Internal Medicine, University of
Goettingen, Goettingen, Germany
Abstract and Introduction
Abstract
Objective: This international, multicentre, 16-week, double-blind,
parallel, two-arm, randomised study was conducted to compare the
effects on blood pressure and tolerability of the angiotensin II (Ang
II) AT1 receptor antagonist losartan and captopril in patients with
mild to moderate hypertension and impaired renal function.
Patients: 102 of the total of 129 patients (mean age 55.2 years)
having any form of secondary hypertension except renal artery stenosis
were recruited from 18 centres in 10 countries. Mild hypertension was
defined as a sitting diastolic blood pressure (SiDBP) of 95 to 105mm
Hg, moderate hypertension as 106 to 115mm Hg, while creatinine
clearance was required to be in the range of 20 to 60 ml/min/1.73m2.
Interventions: The initial 4-week placebo period was followed by 12
weeks of treatment with losartan 50mg, possibly titrated to 100mg,
once daily (group 1, n = 64) or 25mg captopril, possibly titrated to
50mg, twice daily (group 2, n = 65). Main Outcome Measures:
Antihypertensive efficacy was evaluated by the reduction of blood
pressure (BP) after 12 weeks. The main efficacy measurement was the
SiDBP. Secondary end-points included sitting systolic and standing BP,
creatinine clearance, total proteinuria, total cholesterol,
triglycerides and high density lipoprotein cholesterol levels.
Tolerability was assessed by the incidence of adverse events and by
clinical and laboratory tolerability measurements.
Results: After 12 weeks' administration of losartan a reduction of
12.2±10.2mm Hg in SiDBP and 15.5±18.0mm Hg in sitting systolic blood
pressure (SiSBP) was observed, compared with 11.2±11.4mm Hg and
15.6±20.6mm Hg, respectively, in captopril-treated patients. Thus,
there was no statistically significant difference between the two
groups, which was also consistent with the other parameters recorded.
In the losartan group, total proteinuria was significantly decreased
at the end of the study. Creatinine clearance, lipids and the
proportion of patients with clinical adverse experiences showed no
remarkable changes at all in the two groups, although such experiences
affecting the respiratory system, especially cough, appeared
significantly more often (p < 0.034) in captopril-treated patients.
Conclusions: Losartan could be as suitable as captopril as an
antihypertensive agent in cases where renal function is impaired.
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