The renal and cardiovascular effects of natriuretic peptides
The landmark report by de Bold et al. in 1981 signified the heart as one of the endocrine organs involved in fluid and salt balance (de Bold AJ, Borenstein HB, Veress AT, Sonnenberg H. Life Sci 28: 89–94, 1981). Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are secreted from cardiomyocytes in response to cardiac stretch as in the case of heart failure, whereas C-type natriuretic peptide (CNP) is secreted from endothelial and renal cells in response to cytokines and endothelium-dependent agonists, such as acetylcholine. Binding ANP or BNP to natriuretic peptide receptor A induces cyclic guanylyl...
Source: AJP: Advances in Physiology Education - April 4, 2017 Category: Universities & Medical Training Authors: Wong, P. C. Y., Guo, J., Zhang, A. Tags: STAYING CURRENT Source Type: research

Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT) [Vitamins, minerals, and phytochemicals]
Background: The effect of folic acid supplementation on uric acid (UA) concentrations is still inconclusive. Objective: We aimed to test the efficacy of folic acid therapy in reducing serum UA in hypertensive patients. Design: A total of 15,364 hypertensive patients were randomly assigned to a double-blind daily treatment with a single tablet that contained 10 mg enalapril and 0.8 mg folic acid (n = 7685) or 10 mg enalapril alone (n = 7679). The main outcome was the change in serum UA, which was defined as UA at the exit visit minus that at baseline. Secondary outcomes were as follows: 1) controlled hyperuricemia (UA concentration
Source: American Journal of Clinical Nutrition - April 3, 2017 Category: Nutrition Authors: Qin, X., Li, Y., He, M., Tang, G., Yin, D., Liang, M., Wang, B., Nie, J., Huo, Y., Xu, X., Hou, F. F. Tags: Research Need: Role of Nutrition in Health Maintenance, Research Need: Role of Nutrition in Medical Management Vitamins, minerals, and phytochemicals Source Type: research

Association of obstructive sleep apnea with arterial stiffness and nondipping blood pressure in patients with hypertension
In conclusion, OSA is independently associated with arterial stiffness and nondipping blood pressure in patients with hypertension regardless of sex. (Source: The Journal of Clinical Hypertension)
Source: The Journal of Clinical Hypertension - April 1, 2017 Category: Cardiology Authors: Raimundo Jenner, Fernanda Fatureto ‐Borges, Valéria Costa‐Hong, Heno F. Lopes, Sandra H. Teixeira, Elias Marum, Dante A. M. Giorgi, Fernanda M. Consolim‐Colombo, Luiz A. Bortolotto, Geraldo Lorenzi‐Filho, Eduardo M. Krieger, Luciano F. Drager Tags: ORIGINAL PAPER Source Type: research

Abstract 019: Real-World Use of Sacubitril/ Valsartan in Heart Failure in the First Year Following FDA Approval [Session Title: Poster Session I]
Discussion: These finding suggest that the uptake of sacubitril/ valsartan has been slow in the first year after FDA approval. While the majority of prescription costs are covered by the health plan, OOP costs are still much higher than other guideline-recommended HF medications. Further studies are needed to determine if uptake of sacubril/ valsartan continues to rise and if the higher prescription cost is associated with lower downstream costs of hospitalization and mortality benefit. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Sangaralingham, L. R., Sangaralingham, S. J., Van Houten, H. K., Shah, N. D., Adigun, R. O., Dunlay, S. M. Tags: Session Title: Poster Session I Source Type: research

Abstract 073: Maximizing Sacubitril/Valsartan Clinical Benefit Under Budget Constraints [Session Title: Poster Session I]
Conclusions: In healthcare settings under budget constraints, payers can maximize clinical outcomes in HF patients, by prioritizing sacubitril/valsartan therapy to sub-populations that have demonstrated higher benefit in the PARADIGM-HF trial. Advocating the reduction of sacubitril/valsartan prices could enable wider populations to benefit from this promising therapy. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Arbel, R., Hammerman, A., Triki, N., Weinstein, J. M., Grrenberg, D. Tags: Session Title: Poster Session I Source Type: research

Safety of Enalapril in Infants: Data from the Pediatric Heart Network Infant with Single Ventricle Trial
Angiotension converting enzyme (ACE) inhibitor therapy has been shown to improve ventricular function and clinical outcomes in adult patients with heart failure. Despite the lack of safety and efficacy data, empiric use of ACE inhibitor therapy is common in infants and children with cardiomyopathy and congenital heart disease. The Pediatric Heart Network Infant with Single Ventricle (ISV) trial provides the opportunity to describe the safety and adverse effects of enalapril in a large group of infants with complex congenital heart disease. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: K. Mathur, D. Hsu, J. Lamour, S.I. Aydin Source Type: research

Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial
Publication date: Available online 18 March 2017 Source:The Lancet Diabetes & Endocrinology Author(s): Jelena P Seferovic, Brian Claggett, Sara B Seidelmann, Ellen W Seely, Milton Packer, Michael R Zile, Jean L Rouleau, Karl Swedberg, Martin Lefkowitz, Victor C Shi, Akshay S Desai, John J V McMurray, Scott D Solomon Background Diabetes is an independent risk factor for heart failure progression. Sacubitril/valsartan, a combination angiotensin receptor-neprilysin inhibitor, improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), compared with the angiotensin-convertin...
Source: The Lancet Diabetes and Endocrinology - March 18, 2017 Category: Endocrinology Source Type: research

The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF
Conclusions Compared with enalapril, sacubitril/valsartan reduced the risk of both the primary endpoint and a coronary composite outcome in PARADIGM-HF. Additional studies on the effect of sacubitril/valsartan on atherothrombotic outcomes in high risk patients are merited. (Source: American Heart Journal)
Source: American Heart Journal - March 15, 2017 Category: Cardiology Source Type: research

The effects of dual PPAR α/γ agonism compared with ACE inhibition in the BTBRob/ob mouse model of diabetes and diabetic nephropathy
Abstract The leptin‐deficient BTBRob/ob mouse develops progressive albuminuria and morphological lesions similar to human diabetic nephropathy (DN), although whether glomerular hyperfiltration, a recognized feature of early DN that may contribute to renal injury, also occurs in this model is not known. Leptin replacement has been shown to reverse the signs of renal injury in this model, but in contrast, the expected renoprotection by angiotensin‐converting enzyme (ACE) inhibition in BTBRob/ob mice seems to be limited. Therefore, to investigate the potential renal benefits of improved metabolic control in this model, we...
Source: Physiological Reports - March 14, 2017 Category: Physiology Authors: Anette Ericsson, Pernilla Tonelius, Mark Lal, Alan Sabirsh, Gerhard B öttcher, Lena William‐Olsson, Maria Strömstedt, Camilla Johansson, Gina Hyberg, Sofia Tapani, Ann‐Cathrine Jönsson‐Rylander, Robert Unwin Tags: Original Research Source Type: research

China Stroke Primary Prevention Trial: Visit-to-Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients [Stroke]
ConclusionsVisit‐to‐visit SBP variability is an independent predictor of primary stroke in Chinese hypertensive patients. This predictive value depends on the number of blood pressure measurements used to calculate variability but is independent of mean SBP.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885. (Source: JAHA:Journal of the American Heart Association)
Source: JAHA:Journal of the American Heart Association - March 13, 2017 Category: Cardiology Authors: Men, X., Sun, W., Fan, F., Zhao, M., Huang, X., Wang, Y., Liu, L., Liu, R., , Peng, Q., Qin, X., Tang, G., Li, J., Zhang, Y., Cai, Y., Hou, F. F., Wang, B., Xu, X., Cheng, X., Sun, N., Huang, Y., Huo, Y. Tags: Epidemiology, Hypertension, Cerebrovascular Disease/Stroke Original Research Source Type: research

Potential Expanded Indications for Neprilysin Inhibitors
This article reviews the rationale and design for ongoing and future trials of sacubitril/valsartan in cardiovascular and non-cardiovascular disease.Recent FindingsRandomized trial data are lacking for use of sacubitril/valsartan in acute heart failure and advanced heart failure. Mechanistic data from animal studies suggest a role for neprilysin inhibition in the treatment of post-myocardial infarction systolic dysfunction and heart failure with preserved ejection fraction. Beyond the cardiovascular system, renal and neurological function may be impacted by neprilysin inhibition. Forthcoming randomized trials will address ...
Source: Current Heart Failure Reports - March 9, 2017 Category: Cardiology Source Type: research

Sacubitril/Valsartan: The Newest Addition to the Toolbox for Guideline-Directed Medical Therapy of Heart Failure
Sacubitril/valsartan combines a neprilysin inhibitor with an angiotensin receptor blocker. As an inhibitor of neprilysin, an enzyme that degrades biologically active natriuretic peptides, this first-in-class therapy increases levels of circulating natriuretic peptides, resulting in natriuretic, diuretic, and vasodilatory effects. In patients with chronic New York Heart Association class II-IV heart failure with reduced ejection fraction, the PARADIGM-HF trial demonstrated that sacubitril/valsartan significantly reduced the primary endpoint of cardiovascular mortality and heart failure hospitalization, compared with enalapr...
Source: The American Journal of Medicine - March 8, 2017 Category: Journals (General) Authors: Jo E. Rodgers Tags: Review Source Type: research

Targeting renin-angiotensin system in malignant hypertension in atypical hemolytic uremic syndrome
We report two pediatric cases of atypical HUS with severe refractory malignant hypertension, in which we targeted the renin-angiotensin system by using intravenous (IV) enalaprilat, oral aliskiren, and oral enalapril with quick and dramatic response of blood pressure. Both drugs, aliskiren and IV enalaprilat, were effective in controlling hypertension refractory to multiple antihypertensive medications. These appear to be promising alternatives in the treatment of severe atypical HUS-induced hypertension and hypertensive emergency. (Source: Indian Journal of Nephrology)
Source: Indian Journal of Nephrology - March 8, 2017 Category: Urology & Nephrology Authors: V Raghunathan SK Sethi MA Dragon-Durey M Dhaliwal R Raina P Jha SB Bansal V Kher Source Type: research

Sacubitril/Valsartan: The Newest Addition to the Toolbox for Guideline Directed Medical Therapy of Heart Failure
Sacubitril/valsartan combines a neprilysin inhibitor with an angiotensin receptor blocker. As an inhibitor of neprilysin, an enzyme that degrade biologically active natriuretic peptides, this first-in-class therapy increases levels of circulating natriuretic peptides resulting in natriuretic, diuretic, and vasodilatory effects. In patients chronic New York Heart Association class II –IV heart failure with reduced ejection fraction, the PARADIGM-HF trial demonstrated that sacubitril/valsartan significantly reduced the primary endpoint of cardiovascular mortality and HF hospitalization compared to enalapril. (Source: T...
Source: The American Journal of Medicine - March 8, 2017 Category: Journals (General) Authors: Jo E. Rodgers Tags: Review Source Type: research

Changes in renal vessels associated with long-term administration of angiotensin converting enzyme inhibitor in Zucker fatty rats.
In this study, we investigated renal afferent arteriolar changes induced by the long-term administration of an angiotensin converting enzyme inhibitor (ACEI) in ZFRs. Materials and Methods Fourteen 6-week-old male ZFRs were divided into two groups (n=14): the ZFR+ACEI group (n=6) was fed a standard diet containing ACEI (Enalapril, 2 mg/kg/day), and the ZFR control group (n=8) for 12 weeks. Blood pressure and proteinuria were examined and morphological studies on kidneys were performed. Results Remarkable proliferative changes in the afferent arteriolar SMCs were frequently observed in the group given ACEI; (66.1 ±...
Source: Journal of Smooth Muscle Research - March 7, 2017 Category: Research Tags: J Smooth Muscle Res Source Type: research

Limitations of Sacubitril/Valsartan in the Management of Heart Failure
Background: The PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure) trial was a double-blind trial that randomized 8442 patients with heart failure (HF) with reduced ejection fraction (HFrEF) to receive twice daily dosing of either 200 mg of LCZ696 or 10 mg of enalapril in addition to standard medical therapy for HF. Areas of Uncertainty: Limitations of this trial include (1) sacubitril has not been tested by itself in the treatment of HFrEF; (2) the maximum recommended dose of valsartan for the treatment of HFrEF was used in this trial, but the max...
Source: American Journal of Therapeutics - March 1, 2017 Category: Drugs & Pharmacology Tags: Brief Reports Source Type: research

Longitudinal association between fasting blood glucose concentrations and first stroke in hypertensive adults in China: effect of folic acid intervention [Cardiovascular disease risk]
Background: Diabetes is a known risk factor for stroke, but data on its prospective association with first stroke are limited. Folic acid supplementation has been shown to protect against first stroke, but its role in preventing first stroke in diabetes is unknown. Objectives: This post hoc analysis of the China Stroke Primary Prevention Trial tested the hypotheses that the fasting blood glucose (FBG) concentration is positively associated with first stroke risk and that folic acid treatment can reduce stroke risk associated with elevated fasting glucose concentrations. Design: This analysis included 20,327 hypertensive ad...
Source: American Journal of Clinical Nutrition - March 1, 2017 Category: Nutrition Authors: Xu, R. B., Kong, X., Xu, B. P., Song, Y., Ji, M., Zhao, M., Huang, X., Li, P., Cheng, X., Chen, F., Zhang, Y., Tang, G., Qin, X., Wang, B., Hou, F. F., Dong, Q., Chen, Y., Yang, T., Sun, N., Li, X., Zhao, L., Ge, J., Ji, L., Huo, Y., Li, J. Tags: Cardiovascular disease risk Source Type: research

What proportion of patients with chronic heart failure are eligible for sacubitril –valsartan?
Abstract AimsThe PARADIGM‐HF trial showed that sacubitril–valsartan, an ARB–neprilysin inhibitor, is more effective than enalapril for some patients with heart failure (HF). It is uncertain what proportion of patients with HF would be eligible for sacubitril–valsartan in clinical practice. Methods and resultsBetween 2001 and 2014, 6131 patients consecutively referred to a community HF clinic with suspected HF were assessed. The criteria required to enter the randomized phase of PARADIGM‐HF, including symptoms, NT‐proBNP, and current treatment with or without target doses of ACE inhibitors or ARBs, w...
Source: European Journal of Heart Failure - February 27, 2017 Category: Cardiology Authors: Pierpaolo Pellicori, Alessia Urbinati, Parin Shah, Alexandra MacNamara, Syed Kazmi, Riet Dierckx, Jufen Zhang, John G.F. Cleland, Andrew L. Clark Tags: Original Article Source Type: research

Comparing six antihypertensive medication classes for preventing new ‐onset diabetes mellitus among hypertensive patients: a network meta‐analysis
In this study, the effectiveness of six antihypertensive agents with respect to NOD prevention in hypertensive patients was assessed. A network meta‐analysis was conducted to compare the efficacy of specific drug classes. PubMed and Embase databases were searched for relevant articles. Results of the pairwised meta‐analysis were illustrated by odd ratios (OR) and a corresponding 95% confidence interval (CI). The probabilities and outcome of each treatment were ranked and summarized using the surface under the cumulative ranking curve (SUCRA).Twenty‐three trials were identified, including 224,832 patients with an aver...
Source: Journal of Cellular and Molecular Medicine - February 23, 2017 Category: Molecular Biology Authors: Yang Yang, Huilan Xu Tags: Original Article Source Type: research

Comparing six antihypertensive medication classes for preventing new-onset diabetes mellitus among hypertensive patients: a network meta-analysis.
In this study, the effectiveness of six antihypertensive agents with respect to NOD prevention in hypertensive patients was assessed. A network meta-analysis was conducted to compare the efficacy of specific drug classes. PubMed and Embase databases were searched for relevant articles. Results of the pairwised meta-analysis were illustrated by odd ratios (OR) and a corresponding 95% confidence interval (CI). The probabilities and outcome of each treatment were ranked and summarized using the surface under the cumulative ranking curve (SUCRA).Twenty-three trials were identified, including 224,832 patients with an average fo...
Source: J Cell Mol Med - February 23, 2017 Category: Molecular Biology Authors: Yang Y, Xu H Tags: J Cell Mol Med Source Type: research

Cerebral small vessel disease predisposes to temporal lobe epilepsy in spontaneously hypertensive rats.
Abstract The link between cerebral small vessel disease (CSVD) and epilepsy has been poorly investigated. Some reports suggest that CSVD may predispose to temporal lobe epilepsy (TLE). Aim of this study was to evaluate whether spontaneously hypertensive rats (SHRs), an established model of systemic hypertension and CSVD, have a propensity to develop TLE more than generalized seizures. To this aim, amygdala kindling, as a model of TLE, and pentylenetetrazole (PTZ)-induced kindling, as a model of generalized seizures, have been used to ascertain whether SHRs are more prone to TLE as compared to Wistar Kyoto control ...
Source: Brain Research Bulletin - February 15, 2017 Category: Neurology Authors: Russo E, Leo A, Scicchitano F, Donato A, Ferlazzo E, Gasparini S, Cianci V, Mignogna C, Donato G, Citraro R, Aguglia U, De Sarro G Tags: Brain Res Bull Source Type: research

The Nephroprotective Effect of Folic Acid
In this study, Xu et al demonstrated that low-dose folic acid treatment in addition to enalapril in patients with hypertension without prior cardiovascular events reduced the incidence and progression of chronic kidney disease (CKD) compared with treatment with enalapril alone. Although the mechanism of this effect remains to be proven, decreases in plasma homocysteine are a potential explanation. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - February 1, 2017 Category: Internal Medicine Source Type: research

Systolic blood pressure, cardiovascular outcomes and efficacy and safety of sacubitril/valsartan (LCZ696) in patients with chronic heart failure and reduced ejection fraction: results from PARADIGM-HF
We examined the association between SBP and outcomes in the Prospective Comparison of angiotensin receptor-neprilysin inhibitor (ARNI) with an angiotensin-converting enzyme (ACE) inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure trial (PARADIGM-HF), as well as the effect of sacubitril/valsartan, compared with enalapril, according to baseline SBP.MethodsWe analysed the effect of treatment on SBP and on the primary composite outcome (cardiovascular death or heart failure hospitalization), its components and all-cause death. We examined baseline SBP as a categorical (
Source: European Heart Journal - February 1, 2017 Category: Cardiology Source Type: research

Variability in response to albuminuria ‐lowering drugs: true or random?
AimsAlbuminuria‐lowering drugs have shown different effect size in different individuals. Since urine albumin levels are known to vary considerably from day‐to‐day, we questioned whether the between‐individual variability in albuminuria response after therapy initiation reflects a random variability or a true response variation to treatment. In addition, we questioned whether the response variability is drug dependent. MethodsTo determine whether the response to treatment is random or a true drug response, we correlated in six clinical trials the change in albuminuria during placebo or active treatment (on‐treatm...
Source: British Journal of Clinical Pharmacology - February 1, 2017 Category: Drugs & Pharmacology Authors: Sergei I. Petrykiv, Dick Zeeuw, Frederik Persson, Peter Rossing, Ron T. Gansevoort, Gozewijn D. Laverman, Hiddo J. L. Heerspink Tags: PHARMACODYNAMICS Source Type: research

Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT).
Abstract BACKGROUND: The effect of folic acid supplementation on uric acid (UA) concentrations is still inconclusive. OBJECTIVE: We aimed to test the efficacy of folic acid therapy in reducing serum UA in hypertensive patients. DESIGN: A total of 15,364 hypertensive patients were randomly assigned to a double-blind daily treatment with a single tablet that contained 10 mg enalapril and 0.8 mg folic acid (n = 7685) or 10 mg enalapril alone (n = 7679). The main outcome was the change in serum UA, which was defined as UA at the exit visit minus that at baseline. Secondary outcomes were as follows: 1) contro...
Source: The American Journal of Clinical Nutrition - February 1, 2017 Category: Nutrition Authors: Qin X, Li Y, He M, Tang G, Yin D, Liang M, Wang B, Nie J, Huo Y, Xu X, Hou FF Tags: Am J Clin Nutr Source Type: research

Effect of telmisartan and enalapril on ventricular remodeling and kidney prognosis of patients with coronary artery disease complicated with diabetic nephropathy.
Authors: Hou Y, Zhang F, Liu Z, Su S, Wu X, Wang Z Abstract The aim of the present study was to compare the value of telmisartan and enalapril on ventricular remodeling and kidney prognosis of patients with coronary artery disease complicated with diabetic nephropathy, and provide discussion on clinical reasonably chosen medicine. A total of 60 cases of coronary artery disease complicated with diabetic nephropathy were randomly divided for telmisartan (80 mg/day) treatment (n=32), enalapril (10 mg/day) treatment (n=28), while the rest of the therapy was kept the same. After 12 weeks, the clinical effects were compa...
Source: Experimental and Therapeutic Medicine - January 27, 2017 Category: Journals (General) Tags: Exp Ther Med Source Type: research

Longitudinal association between fasting blood glucose concentrations and first stroke in hypertensive adults in China: effect of folic acid intervention.
Abstract BACKGROUND: Diabetes is a known risk factor for stroke, but data on its prospective association with first stroke are limited. Folic acid supplementation has been shown to protect against first stroke, but its role in preventing first stroke in diabetes is unknown. OBJECTIVES: This post hoc analysis of the China Stroke Primary Prevention Trial tested the hypotheses that the fasting blood glucose (FBG) concentration is positively associated with first stroke risk and that folic acid treatment can reduce stroke risk associated with elevated fasting glucose concentrations. DESIGN: This analysis inc...
Source: The American Journal of Clinical Nutrition - January 25, 2017 Category: Nutrition Authors: Xu RB, Kong X, Xu BP, Song Y, Ji M, Zhao M, Huang X, Li P, Cheng X, Chen F, Zhang Y, Tang G, Qin X, Wang B, Hou FF, Dong Q, Chen Y, Yang T, Sun N, Li X, Zhao L, Ge J, Ji L, Huo Y, Li J Tags: Am J Clin Nutr Source Type: research

Captopril/enalapril inhibit promiscuous esterase activity of carbonic anhydrase at micromolar concentrations: An in vitro study
Publication date: Available online 23 January 2017 Source:Chemico-Biological Interactions Author(s): Sajjad Esmaeili, Mohammad Reza Ashrafi Kooshk, Hadi Adibi, Reza Khodarahmi The inhibitory activity of captopril, a thiol-containing competitive inhibitor of the angiotensin-converting enzyme, ACE, against esterase activity of carbonic anhydrase, CA was investigated. This small molecule, as well as enalapril, was selected in order to represents both thiol and carboxylate, as two well-known metal binding functional groups of metalloprotein inhibitors. Since captopril, has also been observed to inhibit other metalloenzymes su...
Source: Chemico Biological Interactions - January 24, 2017 Category: Biochemistry Source Type: research

Captopril/enalapril inhibit promiscuous esterase activity of carbonic anhydrase at micromolar concentrations: An in vitro study.
Abstract The inhibitory activity of captopril, a thiol-containing competitive inhibitor of the angiotensin-converting enzyme, ACE, against esterase activity of carbonic anhydrase, CA was investigated. This small molecule, as well as enalapril, was selected in order to represents both thiol and carboxylate, as two well-known metal binding functional groups of metalloprotein inhibitors. Since captopril, has also been observed to inhibit other metalloenzymes such as tyrosinase and metallo-beta lactamase through binding to the catalytic metal ions and regarding CA as a zinc-containing metallo-enzyme, in the current st...
Source: Chemico-Biological Interactions - January 23, 2017 Category: Molecular Biology Authors: Esmaeili S, Kooshk MR, Adibi H, Khodarahmi R Tags: Chem Biol Interact Source Type: research

Comparative Results in Treatment of Keloids With Intralesional 5-FU/Kenalog, 5-FU/Verapamil, Enalapril Alone,Verapamil Alone, and Laser: A Case Report and Review of the Literature.
CONCLUSION: The favorable effects of the 5-FU + verapamil combination are new and deserve further exploration. J Drugs Dermatol. 2016;15(11):1442-1447.. PMID: 28095559 [PubMed - in process] (Source: Journal of Drugs in Dermatology)
Source: Journal of Drugs in Dermatology - January 19, 2017 Category: Dermatology Tags: J Drugs Dermatol Source Type: research

Finerenone in diabetic kidney disease – so far, so good
Mineralocorticoid receptor antagonism (MRA) with spironolactone and later with eplerenone has a long and positive history in the management of heart failure. Some 15years ago, shortly after the publication of the Randomized Aldactone Evaluation Study (RALES) (1), two Australian nephrologists, Chrysostomou and Becker, reported their experience of adding spironolactone to enalapril in patients with chronic kidney disease (2). In their study of eight patients with proteinuria>1g/day, the addition of 25mg spironolactone reduced proteinuria by 54%, ostensibly independent of an effect on blood pressure. (Source: Journal of Di...
Source: Journal of Diabetes and Its Complications - January 19, 2017 Category: Endocrinology Authors: Richard E. Gilbert Source Type: research

Using biomarkers to predict and to prevent cardiotoxicity of cancer therapy.
Authors: Cardinale D, Biasillo G, Salvatici M, Sandri MT, Cipolla CM Abstract INTRODUCTION: Cardiotoxicity is a common complication that may compromise the clinical effectiveness of anticancer therapy. The current standard for monitoring cardiac function detects cardiotoxicity only when a functional impairment has already occurred, not allowing for any early preventive strategy. Areas covered: A novel approach, based on the use of biomarkers has recently emerged, resulting in a very effective tool for early, real-time identification, and monitoring of cardiotoxicity. In particular, cardiac troponin elevation durin...
Source: Expert Review of Molecular Diagnostics - January 18, 2017 Category: Laboratory Medicine Tags: Expert Rev Mol Diagn Source Type: research

A Pilot Study Linking Endothelial Injury in Lungs and Kidneys in COPD.
CONCLUSIONS: COPD patients and/or CS-exposed mice have pulmonary and renal endothelial cell injury linked to increased endothelial cell AGEs and RAGE levels. Albuminuria could identify COPD patients in whom ACEi therapy improves renal and lung function by reducing endothelial injury. PMID: 28085500 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)
Source: American Journal of Respiratory and Critical Care Medicine - January 13, 2017 Category: Respiratory Medicine Authors: Polverino F, Laucho-Contreras ME, Petersen H, Bijol V, Sholl LM, Choi ME, Divo M, Pinto-Plata V, Chetta A, Tesfaigzi Y, Celli BR, Owen CA Tags: Am J Respir Crit Care Med Source Type: research

The safety of sacubitril-valsartan for the treatment of chronic heart failure.
Authors: Tyler JM, Teerlink JR Abstract INTRODUCTION: Sacubitril-valsartan is a combination drug that contains the neprilysin inhibitor sacubitril and angiotensin II receptor blocker valsartan. In 2015, the US Food and Drug Administration approved sacubitril-valsartan for treatment of heart failure patients with reduced ejection fraction and New York Heart Association class II-IV symptoms following a large, Phase III clinical trial (PARADIGM-HF) that demonstrated a 20% reduction in the combined primary end-point of death from cardiovascular cause or hospitalization for heart failure compared to enalapril. Areas cov...
Source: Expert Opinion on Drug Safety - January 8, 2017 Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research

Rapid analysis of drug dissolution by paper spray ionization mass spectrometry
Publication date: 20 March 2017 Source:Journal of Pharmaceutical and Biomedical Analysis, Volume 136 Author(s): Yang Liu, Ning Liu, Ya-nan Zhou, Lan Lin, Lan He With a great quantity of solid dosage tested by dissolution technology, developing a rapid and sensitive method to access the content of drug within dissolution media is highly desired by analysts and scientists. Traditionally, dissolution media is not compatible with mass spectrometry since the inorganic salts in the media might damage the mass spectrometer. Here, paper spray ionization mass spectrometry (PSI-MS), one of the ambient mass spectrometry technologies...
Source: Journal of Pharmaceutical and Biomedical Analysis - January 7, 2017 Category: Drugs & Pharmacology Source Type: research

Physical training associated with Enalapril but not to Losartan, results in better cardiovascular autonomic effects.
CONCLUSIONS: Enalapril and Losartan promoted similar beneficial cardiovascular autonomic effects in sedentary animals, while only the association of physical training with Enalapril potentiated these effects. PMID: 28043809 [PubMed - as supplied by publisher] (Source: Autonomic Neuroscience)
Source: Autonomic Neuroscience - December 24, 2016 Category: Neuroscience Authors: Maida KD, Gastaldi AC, de Paula Facioli T, de Araújo JE, de Souza HC Tags: Auton Neurosci Source Type: research

Physical training associated with Enalapril but not to Losartan, results in better cardiovascular autonomic effects
We investigated the cardiovascular autonomic effects of physical training associated with Enalapril or Losartan pharmacological treatments in spontaneously hypertensive rats (SHR). (Source: Autonomic Neuroscience: Basic and Clinical)
Source: Autonomic Neuroscience: Basic and Clinical - December 23, 2016 Category: Neuroscience Authors: Karina Delgado Maida, Ada Clarice Gastaldi, Tabata de Paula Facioli, Jo ão Eduardo de Araújo, Hugo Celso Dutra de Souza Source Type: research

Efficacy and safety of sacubitril/valsartan (LCZ696) in Japanese patients with chronic heart failure and reduced ejection fraction: Rationale for and design of the randomized, double-blind PARALLEL-HF study.
CONCLUSIONS: The design of the PARALLEL-HF study is aligned with the PARADIGM-HF study and aims to assess the efficacy and safety of LCZ696 in Japanese HFrEF patients. PMID: 28024961 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)
Source: Journal of Cardiology - December 23, 2016 Category: Cardiology Authors: Tsutsui H, Momomura S, Saito Y, Ito H, Yamamoto K, Ohishi T, Okino N, Guo W Tags: J Cardiol Source Type: research

A comparison study of the echocardiographic changes in hypertensive patients treated with Telmisartan vs. Enalapril
This study compares the effects of telmisartan and enalapril on the echocardiographic parameters in hypertensive patients. (Source: International Journal of Cardiology)
Source: International Journal of Cardiology - December 22, 2016 Category: Cardiology Authors: Najah R Hadi, Mohammad S Abdulzahra, Laith M Abbas Al-Huseini, Hayder A Al-Aubaidy Source Type: research

An Economic Evaluation of Sacubitril/Valsartan for Heart Failure Patients in the Netherlands
In September 2014, the PARADIGM-HF trial showed the heart failure drug combination sacubitril/valsartan to be superior to enalapril for patients with a reduced ejection fraction. (Source: Value in Health)
Source: Value in Health - December 22, 2016 Category: Global & Universal Authors: Simon van der Pol, Fabian Degener, Maarten J. Postma, Pepijn Vemer Source Type: research

Variability in response to albuminuria lowering drugs: true or random?
AimsAlbuminuria lowering drugs have shown different effect size in different individuals. Since urine albumin levels are known to vary considerably from day‐to‐day, we questioned whether the between‐individual variability in albuminuria response after therapy initiation reflects a random variability or a true response variation to treatment. In addition, we questioned whether the response variability is drug dependent. MethodsTo determine whether the response to treatment is random or a true drug response, we correlated in six clinical trials the change in albuminuria during placebo or active treatment (on‐treatmen...
Source: British Journal of Clinical Pharmacology - December 21, 2016 Category: Drugs & Pharmacology Authors: S. I. Petrykiv, D. Zeeuw, F. Persson, P. Rossing, R. T. Gansevoort, G. D. Laverman, H. J. L. Heerspink Tags: PHARMACODYNAMICS Source Type: research

Gene –Gene Interactions Among PRKCA, NOS3 and BDKRB2 Polymorphisms Affect the Antihypertensive Effects of Enalapril
We examined whether PRKCA (protein kinase C, alpha) polymorphisms (rs887797 C>T, rs1010544 T>C and rs16960228 G>A), or haplotypes, and gene–gene interactions within the ACEi pathway affect the antihypertensive responses in 104 hypertensive patients treated with enalapril as monotherapy. Patients were classified as poor responders (PR) or good responders (GR) to enalapril if their changes in mean arterial pressure were lower or higher than the median value, respectively. Multi‐factor dimensionality reduction was used to characterize interactions among PRKCA, NOS3 (nitric oxide synthase 3) and BDKRB2 (bradyk...
Source: Basic and Clinical Pharmacology and Toxicology - December 20, 2016 Category: Drugs & Pharmacology Authors: Gustavo H. Oliveira ‐Paula, Marcelo R. Luizon, Riccardo Lacchini, Vanessa Fontana, Pamela S. Silva, Celso Biagi, Jose E. Tanus‐Santos Tags: Original Article Source Type: research

Therapeutic efficacy and safety of ACE inhibitors in the hypertensive paediatric population: a review
Conclusion Additional efforts are needed to close the gap between the availability of drugs that are labelled and indicated for paediatric use and the actual drug usage in children, especially in young children, neonates and children with severe hypertension, renal transplantation or severe renal impairment. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - December 14, 2016 Category: Pediatrics Authors: Snauwaert, E., Vande Walle, J., De Bruyne, P. Tags: Drugs: CNS (not psychiatric), Hypertension, Child health Drug therapy Source Type: research

Access to and use of high blood pressure medications in Brazil
CONCLUSIONS Access to medicines for the treatment of high blood pressure may be considered high and many of them are available free of charge. The most commonly used drugs are among those recommended as first-line treatment for high blood pressure control. The percentage of people using more than one drug seems to follow the behavior observed in other countries.RESUMO OBJETIVO Analisar o acesso e a utiliza ção de medicamentos para a hipertensão na população brasileira segundo condições sociais e demográficas. Análise dos dados da Pesquisa Nacional Sobre Acesso,...
Source: Revista de Saude Publica - December 13, 2016 Category: Global & Universal Source Type: research

Brief Communication: Plasma lipid oxidation predicts atherosclerotic status better than cholesterol in diabetic apolipoprotein E deficient mice
Increased levels of oxidative stress have been suggested to play a detrimental role in the development of diabetes-related vascular complications. Here, we investigated whether the concentration of malondialdehyde, a marker of lipid oxidation correlated to the degree of aortic plaque lesions in a proatherogenic diabetic mouse model. Three groups of apolipoprotein E knockout mice were studied for 20 weeks, a control, a streptozotocin-induced diabetic, and a diabetic enalapril-treated group. Enalapril was hypothesized to lower oxidative stress level and thus the plaque burden. Both diabetic groups were significantly differen...
Source: Experimental Biology and Medicine - December 5, 2016 Category: Research Authors: Petersen, K. E., Lykkesfeldt, J., Raun, K., Rakipovski, G. Tags: Pharmacology & amp;amp; Toxicology Source Type: research

Nocturnal antihypertensive treatment in patients with type 1 diabetes with autonomic neuropathy and non-dipping: a randomised, placebo-controlled, double-blind cross-over trial
Conclusions We demonstrated that patients with T1D with CAN and non-dipping can be treated with an ACE inhibitor at night as BD as opposed to MD increased BP dipping, thereby diminishing the abnormal BP profile. The potentially beneficial effect on long-term cardiovascular risk remains to be determined. Trial registration number EudraCT2012-002136-90; Post-results. (Source: BMJ Open)
Source: BMJ Open - December 5, 2016 Category: Journals (General) Authors: Hjortkjaer, H. O., Jensen, T., Kofoed, K. F., Mogensen, U. M., Sigvardsen, P. E., Kober, L., Hilsted, K. L., Corinth, H., Theilade, S., Hilsted, J. Tags: Open access, Cardiovascular medicine, Diabetes and Endocrinology Research Source Type: research

Treatment for hereditary angioedema with normal C1 ‐INH and specific mutations in the F12 gene (HAE‐FXII)
We report our experience treating HAE‐FXII with discontinuation of potential trigger factors and drug therapies. The study included 72 patients with HAE‐FXII. Potential triggers included estrogen‐containing oral contraceptives (eOC), hormonal replacement therapy, or angiotensin‐converting enzyme inhibitors. Drug treatment comprised plasma‐derived C1 inhibitor (pdC1‐INH) for acute swelling attacks and progestins, tranexamic acid, and danazol for the prevention of attacks. Discontinuation of eOC was effective in 25 (89.3%) of 28 women and led to a reduction in the number of attacks (about 90%). After ending hormo...
Source: Allergy - December 1, 2016 Category: Allergy & Immunology Authors: K. Bork, K. Wulff, G. Witzke, J. Hardt Tags: Brief Communication Source Type: research

Unequivocal Evidence Supporting the Segregated Flow Intestinal Model that Discriminates Intestine versus Liver First ‐Pass Removal in PBPK Modeling
Abstract Merits of the segregated flow model (SFM), highlighting the intestine as an inert serosa and active enterocyte c regions, with a smaller fractional (fQ 
Source: Biopharmaceutics and Drug Disposition - December 1, 2016 Category: Drugs & Pharmacology Authors: K. Sandy Pang, Qi Joy Yang, Keumhan Noh Tags: Special Issue Article Source Type: research

Renin-Angiotensin-Aldosterone System Inhibition Increases Podocyte Derivation from Cells of Renin Lineage
Because adult podocytes cannot proliferate and are therefore unable to self-renew, replacement of these cells depends on stem/progenitor cells. Although podocyte number is higher after renin-angiotensin-aldosterone system (RAAS) inhibition in glomerular diseases, the events explaining this increase are unclear. Cells of renin lineage (CoRL) have marked plasticity, including the ability to acquire a podocyte phenotype. To test the hypothesis that RAAS inhibition partially replenishes adult podocytes by increasing CoRL number, migration, and/or transdifferentiation, we administered tamoxifen to Ren1cCreERxRs-tdTomato-R CoRL ...
Source: Journal of the American Society of Nephrology : JASN - November 30, 2016 Category: Urology & Nephrology Authors: Lichtnekert, J., Kaverina, N. V., Eng, D. G., Gross, K. W., Kutz, J. N., Pippin, J. W., Shankland, S. J. Tags: Basic Research Source Type: research

Prognostic Implications of Changes in N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Heart Failure
ConclusionsPatients who attained a significant reduction in NT-proBNP had a lower subsequent rate of cardiovascular death or HF hospitalization independent of the treatment group. Treatment with sacubitril/valsartan was  nearly twice as likely as enalapril to reduce NT-proBNP to values ≤1,000 pg/ml. (Prospective Comparison of ARNI [Angiotensin Receptor–Neprilysin Inhibitor] with ACEI [Angiotensin-Converting–Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial) [PARA DIGM-HF]; NCT01035255.) (Source: Journal of the American College of Cardiology)
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research