Effect of the ACE inhibitor ceronapril on cerebral blood flow in hypertensive patients.

Abstract

OBJECTIVE:

To assess the effect of the angiotensin-converting enzyme inhibitor ceronapril on cerebral blood flow (CBF) in patients with moderate hypertension.

DESIGN:

Patients received chlorthalidone 25 mg for 4 weeks, and if diastolic blood pressure remained in the range of 100-115 mm Hg, they were given titrated doses of ceronapril (10-40 mg/d based on blood pressure response) in addition to chlorthalidone for 9 weeks.

SETTING:

Outpatient research clinic.

SUBJECTS:

Eligible patients had moderate essential hypertension (diastolic blood pressure 100-115 mm Hg) assessed when the patients were receiving no medications. Thirteen patients were entered into the study; 1 withdrew for reasons unrelated to the study drug. Twelve patients (11 men, 1 woman; mean age 52 y) completed the study.

INTERVENTION:

Ceronapril, given with chlorthalidone.

MAIN OUTCOME MEASURES:

CBF measurements were taken at the start and end of ceronapril therapy using intravenous 133Xe; blood pressures were determined weekly.

RESULTS:

Mean arterial blood pressure decreased from 130 +/- 4 to 120 +/- 7 mm Hg after 4 weeks of chlorthalidone administration, and fell further to 108 +/- 8 mm Hg after an additional 9 weeks of combined chlorthalidone-ceronapril therapy (p < 0.05). CBF fell from 44 +/- 15 to 34 +/- 5 mL/min/100 g during the 9 weeks of combined therapy (p = 0.05). No adverse effects consistent with decreased CBF were observed. The decrease in CBF was not linearly correlated with the change in systemic blood pressure, but was strongly correlated (r = -0.937; p < 0.001) with the initial CBF.

CONCLUSIONS:

The decrease in mean arterial blood pressure was not associated with a decrease in CBF. Patients with high CBF may be predisposed to a decrease in CBF when treated with ceronapril and chlorthalidone.

• Authors: N R Cutler, J J Sramek, A Luna, I Mena, E P Brass, N M Kurtz, J J Brennan
• Journal: The Annals of pharmacotherapy (Ann Pharmacother) Vol. 30 Issue 6 Pg. 578-82 (Jun 1996) ISSN: 1060-0280 [Print] United States
• PMID: 8792940 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Diuretics
• Organophosphorus Compounds
• Xenon Radioisotopes
• Proline
• Chlorthalidone
• ceronapril

Topics

• Aged
• Angiotensin-Converting Enzyme Inhibitors (adverse effects, therapeutic use)
• Blood Pressure (drug effects)
• Cerebrovascular Circulation (drug effects)
• Chlorthalidone (therapeutic use)
• Diuretics (therapeutic use)
• Drug Therapy, Combination
• Female
• Homeostasis (drug effects)
• Humans
• Hypertension (drug therapy, physiopathology)
• Male
• Middle Aged
• Organophosphorus Compounds (adverse effects, therapeutic use)
• Proline (adverse effects, analogs & derivatives, therapeutic use)
• Xenon Radioisotopes