Abstract:
:Treatment with angiotensin-converting enzyme (ACE) inhibitors is frequently associated with persistent dry cough. This side effect is thought to be due to the non-specific action of ACE inhibitors, which, in addition to suppressing the renin-angiotensin system (RAS), leads to the accumulation of kinins, encephalins and other biologically active peptides. Candesartan cilexetil is a new, long-acting angiotensin II type 1 (AT 1 ) receptor blocker, which offers a more specific means of suppressing the RAS than can be achieved with ACE inhibitors. In this study, we compared the incidence and severity of cough during treatment with candesartan cilexetil, enalapril and placebo in patients with hypertension and enalapril-induced cough. Men and women, aged 20-80 years, with a history of medically treated primary hypertension and ACE-inhibitor-related cough were enrolled. The presence of cough was confirmed during a 4-week challenge period with enalapril, 10 mg, which abated during a subsequent 4-week washout period with placebo. Patients with confirmed ACE-inhibitor-related cough were then randomized to double-blind treatment with candesartan cilexetil, 8 mg once daily ( n = 62), enalapril, 10 mg once daily ( n = 66), or placebo ( n = 26). Baseline blood pressure was similar in all groups. Although blood pressure was recorded during the study, this was for safety monitoring, and the measurements were not standardized in relation to study drug intake or time of day. The frequency of dry cough was recorded on a visual analogue scale (VAS). For each assessment, patients marked a cross on a straight horizontal 100 mm line, rating cough frequency from 'none of the time( at one end of the line to 'all of the time( at the other end. The impact of treatment on quality of life was also studied, using the Symptom Assessment (SA) questionnaire and the Minor Symptom Evaluation (MSE) profile. The SA questionnaire assessed the severity of nine symptoms, including dry cough, by means of a five-graded Likert scale (not at all, a little, moderately, quite a bit, extremely). Changes in the three dimensions of the MSE profile - contentment, vitality and sleep - were recorded using a VAS. Candesartan cilexetil was superior to enalapril regarding the change in frequency ( p = 0.001) and severity ( p < 0.001) of dry cough. After 8 weeks of treatment, the proportions of patients with cough were 26.9% for placebo, 35.5% for candesartan cilexetil and 68.2% for enalapril ( p < 0.001, candesartan cilexetil versus enalapril; p > 0.20, candesartan cilexetil versus placebo). Treatment with candesartan cilexetil did not compromise patients' well-being. Compared with placebo, candesartan cilexetil was superior in terms of its effect on contentment; similar trends were noted for vitality and sleep, although the differences were not significant. When all adverse events were considered, candesartan cilexetil was very well tolerated. No serious adverse events occurred in the candesartan cilexetil or placebo groups, while three patients in the enalapril group reported serious adverse events (chest pain, agranulocytosis, accidental fracture). No treatment-related changes of clinical relevance could be found with regard to laboratory variables, ECG or vital signs/physical findings, except the anticipated blood pressure reduction in the active treatment groups. In conclusion, candesartan cilexetil is not associated with cough in hypertensive patients with previous ACE-inhibitor-induced cough. The incidence of dry cough in patients treated with candesartan cilexetil was similar to that of placebo and lower than that of enalapril.
journal_name
Blood Pressjournal_title
Blood pressureauthors
Tanser P,Campbell LM,Carranza J,Karrasch J,Toutouzas P,Watts Rdoi
10.1080/080370500439290subject
Has Abstractpub_date
2000-01-01 00:00:00pages
56issue
sup1eissn
0803-7051issn
1651-1999journal_volume
9pub_type
杂志文章相关文献
BLOOD PRESSURE文献大全abstract:INTRODUCTION:Detection and treatment of left ventricular hypertrophy (LVH) in hypertension is important in order to reduce cardiovascular risk. The product of QRS voltage and duration (e.g. Cornell voltage-duration product; CorP), is a good marker of LVH and the current study was designed to determine the prevalence of...
journal_title:Blood pressure
pub_type: 杂志文章,多中心研究
doi:10.1080/08037050802059092
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To study whether the cardiovascular preventive effect of antihypertensive therapy can be explained solely by the reduction in office blood pressure, and to what extent the risk of stroke and cardiac events is associated with in-study diastolic blood pressure (DBP) and systolic blood pressure (SBP). DESIGN:Th...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.3109/08037059209077513
更新日期:1992-10-01 00:00:00
abstract:AIMS:The purpose of the study was to assess the effect of percutaneous transluminal coronary angioplasty (PTCA) on plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level in hypertensive and normotensive subjects with and without systolic left ventricular dysfunction. METHODS AND RESULTS:Forty patients affec...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/08037050600804814
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To determine the factors influencing general practitioners' prescribing for patients with moderate hypertension, and to investigate their ability to assess patients' absolute risk of cardiovascular disease. DESIGN:Decision-making was assessed by a postal questionnaire involving five standardised example pati...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/080370500300000897
更新日期:2000-01-01 00:00:00
abstract::Whole-body insulin sensitivity has been shown to be impaired in subjects with increased left ventricular relative wall thickness (RWT) and in hypertensive subjects with left ventricular hypertrophy, but the relation between myocardial insulin sensitivity and RWT or left ventricular mass index (LVMI) in normotension is...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章
doi:10.1080/080370501750183354
更新日期:2001-01-01 00:00:00
abstract::Plasma level of adrenaline has been reported to be elevated in borderline hypertension. However, its role in developing and maintaining hypertension is still not completely understood. This study aimed to estimate the role of plasma adrenaline in developing hypertension. Ten patients with borderline hypertension (BHT)...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037059509077578
更新日期:1995-03-01 00:00:00
abstract::The HEART project was conducted in general practice to determine whether lifestyle strategies, aimed at increasing physical activity and dietary modification, can be substituted for drug therapy in patients who have been well controlled on antihypertensive medication. In addition to blood pressure (BP) and risk factor...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/080370500448650
更新日期:2000-01-01 00:00:00
abstract:AIMS:Cardiovascular disease is the leading cause of mortality and morbidity in the western world and has reached epidemic proportions. The incidence of congestive heart failure (CHD) and hypertension is also rising rapidly in many of the affluent Arab nations and cardiovascular diseases continue to be a leading cause o...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/08037050310028462
更新日期:2004-01-01 00:00:00
abstract::We compared the effects of amlodipine and verapamil slow release on autonomic responses to a 5-min mental arithmetic test (MST) in patients with mild to moderate hypertension. Twenty subjects received 8 weeks of verapamil slow release 240 mg or amlodipine 10 mg in a double-blind crossover design, both after 4 weeks' p...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/08037050152112096
更新日期:2001-01-01 00:00:00
abstract::The balance between matrix metalloproteinases (MMP) and their tissue inhibitors (TIMP) plays a key role in the development of hypertension and obesity. We aimed to evaluate the levels of MMP-2 and 9 and TIMP-2 and -1 in obese and non-obese apparent treatment-resistant hypertensive subjects (aTRH) and its association w...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章
doi:10.1080/08037051.2016.1249336
更新日期:2017-04-01 00:00:00
abstract::The effectiveness of hypertension treatment remains low in many developed countries. The aim of our study was to evaluate the treatment effectiveness in hypertensives treated by general practitioners (GPs) in Poland. Twenty thousand three hundred and five hypertensive patients (mean age 60.1 +/- 12.0 years, 9918 women...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/08037050310015458
更新日期:2003-01-01 00:00:00
abstract:UNLABELLED:Resistant hypertensive (RHTN) patients have endothelial dysfunction and aldosterone excess, which contribute to the development of resistance to antihypertensive treatment and cardiovascular complications. Biophysical forces within the arterial wall provide functional regulation of arterial stiffness. Caroti...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037051.2011.617045
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to determine if there is an association of different gene polymorphisms of renin-angiotensin system and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH) in St Petersburg population. PATIENTS AND METHODS:We examined 156 patients (the mean age 49+...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/080370501753182343
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To compare unattended blood pressure (BP) with two attended BP, with 24-h ambulatory (ABPM) and central BP measurements in hypertensive patients with (DMs) and without diabetes (HTs). METHODS:In the same hypertension clinic we evaluate 129 consecutive HTs (56% female, 59 + 16 yrs) and 91 DMs (62% female, 64 ...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/08037051.2019.1568184
更新日期:2019-04-01 00:00:00
abstract::Hypertensive patients who are at high risk of developing cardiovascular (CV) complications have become the focus of modern treatment guidelines. The choice of antihypertensive therapies in these patients should be evidence-based: in particular, there should be evidence of a beneficial impact on CV events in addition t...
journal_title:Blood pressure
pub_type: 杂志文章,评审
doi:10.1080/08037050211264
更新日期:2002-01-01 00:00:00
abstract::It has previously been documented that patients with obstructive sleep apnoea (OSA) have an abnormal blood pressure (pressor) response to acute hypoxia when awake. The relationship between hypoxic chemosensitivity and 24 h blood pressure in OSA is not known. Twenty-four hour ambulatory BP (ABP) was measured at 15 min ...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037059409101521
更新日期:1994-03-01 00:00:00
abstract::Sleep disordered breathing has increasingly been recognised as a frequent cause of ill-health in the community. Moderate or severe forms of the most common condition, obstructive sleep apnea (OSA), occur in up to 12% of the adult male population. A substantial body of literature has been published on the potential rel...
journal_title:Blood pressure
pub_type: 杂志文章,评审
doi:10.3109/08037059309077548
更新日期:1993-09-01 00:00:00
abstract::Purpose: To study the differences in attitudes towards hypertension and drug treatment between patients persistent and non-persistent to antihypertensive drug treatment. Materials and methods: Cross-sectional study on patients with hypertension treated at 25 primary healthcare centres in Stockholm, Sweden. Questionnai...
journal_title:Blood pressure
pub_type: 杂志文章,多中心研究
doi:10.1080/08037051.2019.1627858
更新日期:2019-10-01 00:00:00
abstract:AIM:Our aim was to study different levels of high blood pressure and normal blood pressure (reference) to calculate the hazard ratios (HRs) for cardiovascular and total mortality in men and women with adjustments for many covariates. METHODS:A health-screening program was offered to a population-based sample in Stockh...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/08037050903013881
更新日期:2009-01-01 00:00:00
abstract::Physical pain is a major trigger for changes in many homeostatic systems of the body physiology. Our aim was to study the relationship between blood pressure, metabolism and pain perception in subjects with chronic pain symptoms. This was undertaken in a population-based study in primary health care, including subject...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037059709062085
更新日期:1997-09-01 00:00:00
abstract::Northern Africans constitute one of the largest immigrant groups in France; however, limited data are available on their cardiovascular risk factors. We carried out a retrospective cross-sectional study in a French hypertension unit, comparing 719 patients born in Northern Africa to 3558 controls born in Europe, indiv...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037050903464741
更新日期:2010-04-01 00:00:00
abstract::Purpose: Elevated blood pressure induces electrocardiographic changes and is associated with an increase in cardiovascular disease later in life compared to normal blood pressure levels. The purpose of this study was to evaluate the association between normal to high normal blood pressure values (90-139/50-89 mmHg) an...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/08037051.2019.1673149
更新日期:2020-04-01 00:00:00
abstract::Neurohormonal changes in congestive heart failure (CHF) include an enhanced peripheral sympathetic nerve activity which results in increased release of noradrenaline, neuropeptide Y and ATP. To examine if such changes in CHF would modulate peripheral pre- and postsynaptic receptors of ATP and its degradation product a...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/080370500453500
更新日期:2000-01-01 00:00:00
abstract::Effective antihypertensive care is not possible without regular and reliable blood pressure measurements. The use of blood pressure home measurement has increased a lot during the last years. Various methods have been used in communication between the patients and physicians. In a randomized study we compared traditio...
journal_title:Blood pressure
pub_type: 杂志文章,随机对照试验
doi:10.3109/08037051003718457
更新日期:2010-10-01 00:00:00
abstract::The effects of spirapril and isradipine on blood pressure, urinary albumin excretion and sodium-volume homeostasis in hypertensive insulin-dependent diabetic patients with nephropathy were assessed. Fifteen Type 1 diabetic patients aged 28-53 years with a diabetes duration of 19-37 years were studied. All had hyperten...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3109/08037059309077172
更新日期:1993-12-01 00:00:00
abstract::Serotonin stimulates phospholipase A(2)(PLA(2)) leading to the production of prostaglandin products, several of which are vasoconstrictors. We hypothesised that the elevated vascular responsiveness to serotonin in deoxycorticosterone acetate (DOCA)-hypertensive rats is due in part to augmented production of vasoconstr...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037059609062117
更新日期:1996-03-01 00:00:00
abstract::Using both in vitro and in vivo techniques, it has repeatedly been shown that endothelium-dependent vasodilation (EDV) is impaired in different forms of experimental hypertension (SHR, Dahl salt-sensitive rat, DOCA-salt rat and renovascular hypertension). EDV has also been found to be impaired in primary, as well as i...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.1080/080370500439362
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:The main objective was to compare the mean change in augmentation index of hypertensive patients treated with nebivolol or atenolol. METHODS:Multicenter, double-blind randomized study conducted in six Spanish centers. We enrolled outpatients between the ages of 40 and 65 years with mild or moderate essent...
journal_title:Blood pressure
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3109/08037051.2013.840421
更新日期:2014-06-01 00:00:00
abstract::The BBB study (Swedish for Behandla Blodtryck Bättre or Treat Blood Pressure Better) was a multicenter trial designed to investigate three aspects of antihypertensive treatment: i) Is it possible to lower the diastolic blood pressure further in "well-treated" hypertensive patients through intensified therapy? ii) Can ...
journal_title:Blood pressure
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.3109/08037059409102265
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:There are controversial results regarding the endothelial function in patients with white coat hypertension (WCH). The aim of this study was to assess endothelial function measuring nitric oxide (NO) and C-reactive protein (CRP) level in WCH and to compare those with essential hypertension (EH) and healthy s...
journal_title:Blood pressure
pub_type: 杂志文章
doi:10.3109/08037051.2011.649541
更新日期:2012-10-01 00:00:00