Affiliation:
1. Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
2. Unit of Internal Medicine, Policlinico S. Orsola, University of Bologna, Bologna, Italy
Abstract
Hypertension and kidney disease often coexist, further increasing the risk of future cardiovascular
events. Treatment of hypertensive adults with an angiotensin converting enzyme inhibitor
in case of concomitant kidney disease may slow disease progression. The third-generation
liphophilic angiotensin converting enzyme inhibitor zofenopril, administered alone or combined
with a thiazide diuretic, has proved to be effective in lowering blood pressure in hypertensive patients
and to reduce the risk of fatal and non-fatal events in post-acute myocardial infarction and
heart failure. In almost three-hundred hypertensive patients with kidney impairment zofenopril administered
for 12 weeks showed a similar blood pressure-lowering effect irrespective of the stage of
the disease, with larger effects in combination with a thiazide diuretic, particularly in patients with
slightly or moderately impaired kidney function. In animal models, zofenopril produced a significant
and long-lasting inhibition of kidney angiotensin converting enzyme inhibitor and prevented
kidney morphological and functional alterations following kidney ischemia-reperfusion injury.
Treatment of hypertensive patients for 18 weeks with a combination of zofenopril 30 mg and hydrochlorothiazide
12.5 mg resulted in a reduction in albumin creatinine ratio of 8.4 mg/g (49.6%
reduction from baseline values) and no changes in glomerular filtration rate, variations in line with
those obtained in the control group treated with a combination of irbesartan 150 mg and hydrochlorothiazide
12.5 mg. Thus, some preliminary evidence exists to support that relatively long-term
treatment with the angiotensin converting enzyme inhibitor zofenopril alone or combined with hydrochlorothiazide
is effective in controlling blood pressure and may confer some kidney protection
due to ACE inhibition properties.
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics,General Medicine
Cited by
1 articles.
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