TY - JOUR

T1 - The effect of fosinopril sodium on cerebral blood flow in moderate essential hypertension

AU - Waldemar, G

AU - Ibsen, H

AU - Strandgaard, S

AU - Andersen, A R

AU - Rasmussen, S

AU - Paulson, O B

PY - 1990/6

Y1 - 1990/6

N2 - The effect of the angiotensin converting enzyme (ACE) inhibitor fosinopril sodium on regional cerebral blood flow (rCBF) was investigated in 8 patients with moderate essential hypertension. A constant dose of chlorthalidone (25 mg/day) was given to stimulate the renin angiotensin system, and fosinopril sodium was given in incremental doses (10 to 40 mg/day) with the aim of obtaining a diastolic blood pressure at or below 90 mm Hg. Regional CBF was measured with xenon-133 inhalation tomography. Repetitive measurements were made at the start of treatment and again after 4 to 12 weeks treatment in the resting supine position, and during lower body negative pressure (LBNP) as a substitute for the upright position. Four hours after the first 10 mg dose of fosinopril the mean arterial pressure (MAP) had been reduced from 127 +/- 13 mm Hg to 105 +/- 9 mm Hg (P less than .01) without any significant change in mean CBF (55 +/- 9 mL/(100 g X min) at baseline versus 52 +/- 9 mL/(100 g X min) after fosinopril). After prolonged treatment with chlorthalidone and fosinopril, mean CBF was still unchanged from baseline levels, when measured 4 and 24 h after a single dose of fosinopril, despite a 10% reduction in MAP (P less than .01). LBNP did not lead to any significant change in rCBF. The regional distribution of CBF was normal in all patients throughout the study. We conclude that treatment with fosinopril sodium causes a moderate fall in blood pressure without any adverse effects on rCBF.

AB - The effect of the angiotensin converting enzyme (ACE) inhibitor fosinopril sodium on regional cerebral blood flow (rCBF) was investigated in 8 patients with moderate essential hypertension. A constant dose of chlorthalidone (25 mg/day) was given to stimulate the renin angiotensin system, and fosinopril sodium was given in incremental doses (10 to 40 mg/day) with the aim of obtaining a diastolic blood pressure at or below 90 mm Hg. Regional CBF was measured with xenon-133 inhalation tomography. Repetitive measurements were made at the start of treatment and again after 4 to 12 weeks treatment in the resting supine position, and during lower body negative pressure (LBNP) as a substitute for the upright position. Four hours after the first 10 mg dose of fosinopril the mean arterial pressure (MAP) had been reduced from 127 +/- 13 mm Hg to 105 +/- 9 mm Hg (P less than .01) without any significant change in mean CBF (55 +/- 9 mL/(100 g X min) at baseline versus 52 +/- 9 mL/(100 g X min) after fosinopril). After prolonged treatment with chlorthalidone and fosinopril, mean CBF was still unchanged from baseline levels, when measured 4 and 24 h after a single dose of fosinopril, despite a 10% reduction in MAP (P less than .01). LBNP did not lead to any significant change in rCBF. The regional distribution of CBF was normal in all patients throughout the study. We conclude that treatment with fosinopril sodium causes a moderate fall in blood pressure without any adverse effects on rCBF.

KW - Adult

KW - Aged

KW - Antihypertensive Agents/pharmacology

KW - Blood Pressure/drug effects

KW - Cerebrovascular Circulation/drug effects

KW - Chlorthalidone/pharmacology

KW - Female

KW - Fosinopril

KW - Humans

KW - Hypertension/diagnostic imaging

KW - Lower Body Negative Pressure

KW - Male

KW - Middle Aged

KW - Organophosphorus Compounds/blood

KW - Proline/analogs & derivatives

KW - Rest

KW - Tomography, Emission-Computed, Single-Photon

U2 - 10.1093/ajh/3.6.464

DO - 10.1093/ajh/3.6.464

M3 - Journal article

C2 - 2142429

VL - 3

SP - 464

EP - 470

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 6 Pt 1

ER -