enalapril and Cerebral-Infarction

Vascular factors have been shown to be associated with increased risk of dementia. However, clinical trials have so far been unsuccessful, suggesting new approaches are needed. The aim of this study was to use population-based real-world data to investigate risk factors and preventive factors for dementia, including the effects of traditional Chinese medicine (TCM).. This is a retrospective cohort study using LHID2000, a dataset randomly selected from Taiwan's National Health Insurance Research Database. Subjects with occlusion and stenosis of precerebral and cerebral arteries, cerebral atherosclerosis without mention of cerebral infarction, and transient cerebral ischemia were included. Subjects with dementia at baseline were excluded. The primary endpoint was dementia. Data for demographic and clinical comorbid status and treatments administered at baseline in 2000 and at the end of follow-up in 2013 were included.. A total of 4,207 subjects with cerebral vascular disease and no cognitive impairment were included, of whom 392 converted to dementia during an average 5.15-year (SD: 3.79) follow-up. Depression (adjusted HR: 1.54, 95% confidence interval [CI]: 1.13-2.09), osteoporosis (adjusted HR: 1.34, 95% CI: 1.04-1.74), and the use of enalapril (adjusted HR: 1.37, 95% CI: 1.09-1.73) were risk factors for dementia, while nitroglycerin (adjusted HR: 0.67, 95% CI: 0.53-0.85) was a protecting factor, in subjects with cerebrovascular diseases without mention of cerebral infarction. In total, statins were shown to be associated with decreased risk of dementia (HR: 0.73, 95% CI: 0.59-0.91); however, no one statin subtype or TCM had such an effect.. Depression, osteoporosis, and the use of enalapril were associated with a higher risk of dementia, while nitroglycerin might be a protecting factor for dementia, in subjects with cerebrovascular diseases without mention of cerebral infarction.

Topics: Cerebral Infarction; Cerebrovascular Disorders; Dementia; Enalapril; Humans; Nitroglycerin; Osteoporosis; Retrospective Studies; Risk Factors; Taiwan

Posterior reversible encephalopathy syndrome (PRES) and cerebral sinus thrombosis are 2 known complications of acute lymphoblastic leukemia and its treatment. We describe a patient with acute lymphoblastic leukemia whose course was complicated by both of these conditions. This case is novel both for the fact that PRES developed before the initiation of therapy and that PRES was followed shortly by the development of cerebral sinus thrombosis. Our patient's story raises questions about our current understanding of the pathophysiology of PRES, and it suggests that PRES may actually be a predisposing risk factor for cerebral sinus thrombosis.

Topics: Antineoplastic Combined Chemotherapy Protocols; Brain Ischemia; Cerebral Infarction; Child, Preschool; Enalapril; Enoxaparin; Female; Humans; Intracranial Hypertension; Magnetic Resonance Imaging; Neuroimaging; Occipital Lobe; Papilledema; Parietal Lobe; Posterior Leukoencephalopathy Syndrome; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Sinus Thrombosis, Intracranial

Topics: Antihypertensive Agents; Blood Pressure; Cerebral Infarction; Circadian Rhythm; Delayed-Action Preparations; Enalapril; Half-Life; Humans; Hypertension; Myocardial Infarction

We investigated the cerebral blood flow in mild to moderately hypertensive patients with chronic cerebral infarction before and after the administration of bunazosin hydrochloride sustained-release formulation, a selective sympathetic alpha1 receptor blocker.. Eleven mild to moderately hypertensive patients (mean age 65.6 years) with chronic cerebral infarction were studied.. The patients were on enalapril maleate, an angiotensin converting enzyme inhibitor, for one week and then enalapril maleate was switched to bunazosin hydrochloride sustained-release formulation.. The cerebral blood flow study was performed before and 8 weeks after starting the administration of bunazosin hydrochloride sustained-release formulation. Cerebral blood flow was measured using the stable xenon CT method. The picture analysis was performed using AZ-7000. The regional cerebral blood flow was measured by placing the region of interest on the CT images. The regional cerebral blood flows were measured before and 20 minutes after intravenous injection of 17 mg/kg acetazolamide.. The blood flows in the parietal cortex and caudate nucleus 8 weeks after starting the administration of bunazosin hydrochloride sustained-release formulation were significantly greater than those before. The cerebrovascular acetazolamide reactivity in the occipital cortex and caudate nucleus was significantly lower after switching to bunazosin hydrochloride sustained-release formulation than before.. Considering the reports that angiotensin converting enzyme inhibitors show little influence on cerebral blood flow, the present study suggests that bunazosin hydrochloride sustained-release formulation may show a good influence on cerebral blood flow in mild to moderately hypertensive patients with chronic cerebral infarction.

Topics: Acetazolamide; Adrenergic alpha-Antagonists; Aged; Angiotensin-Converting Enzyme Inhibitors; Blood Flow Velocity; Caudate Nucleus; Cerebral Infarction; Cerebrovascular Circulation; Delayed-Action Preparations; Diuretics; Enalapril; Female; Humans; Injections, Intravenous; Male; Occipital Lobe; Parietal Lobe; Quinazolines; Tomography, X-Ray Computed

Topics: Antihypertensive Agents; Brain; Cerebral Angiography; Cerebral Cortex; Cerebral Infarction; Cerebral Revascularization; Child; Drug Therapy, Combination; Enalapril; Female; Furosemide; Hemodynamics; Humans; Hypertension, Renovascular; Moyamoya Disease; Nifedipine; Regional Blood Flow; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The influence of long-term oral administration of enalapril maleate (an angiotensin II-converting enzyme inhibitor) on regional cerebral blood flow (rCBF) was studied in 10 patients with chronic cerebral infarction. The rCBF was measured by a 133Xe inhalation method before and after a mean of sixty-five days' administration of 5 mg of enalapril.. Mean arterial blood pressure (MABP) was mildly decreased in 6 patients, but the average change in MABP was not significant (Endtidal partial pressure of carbon dioxide (PeC02) was not changed significantly. The mean rCBF was increased by 8% after administration of enalapril (0.05 less than p less than 0.1) There was no significant correlation between percent change in MABP and the percent change in rCBF. These results indicate that enalapril has not only antihypertensive action but also a beneficial effect on the cerebral circulation in patients with chronic cerebral infarction.

Topics: Administration, Oral; Aged; Cerebral Infarction; Cerebrovascular Circulation; Chronic Disease; Drug Evaluation; Enalapril; Female; Humans; Hypertension; Male; Middle Aged; Radionuclide Imaging; Xenon Radioisotopes

This study was designed to characterize the nocturnal fall of blood pressure (NFBP) of elderly hypertensive patients (EH), with or without cerebrovascular disease or diabetes mellitus, as measured by automated blood pressure (BP) monitoring. Systolic and diastolic BP and heart rate was measured every 15 minutes in 133 hospitalized patients with nearly similar schedules and diets. The patients were divided into five groups: I, normotensive elderly patients over age 65: II, EH without cardiovascular diseases, controlled without medication: III, EH with cerebral infarction, chronic stage: IV, EH with noninsulin-dependent diabetes mellitus: and V, hypertensives under age 65, without cardiovascular diseases. A significant NFBP was observed in the patients of groups I and V, a significant but smaller NFBP in the hypertensives of groups II and IV, and no NFBP in the patients of group III. Administration of the antihypertensive drugs, enalapril and nifedipine, tended to augment the NFBP. These preliminary observations showed that NFBP did occur in elderly hypertensives but the fall was smaller than that observed in younger hypertensives or elderly normotensives. Although the ambulatory BP measurements were useful in the overall clinical evaluation of elderly patients, NFBP in elderly patients was affected by hypertensive drugs and therefore NFBP should be interpreted with caution.

Topics: Aged; Blood Pressure; Blood Pressure Determination; Cerebral Infarction; Circadian Rhythm; Diabetes Mellitus, Type 2; Enalapril; Female; Humans; Hypertension; Male; Middle Aged; Monitoring, Physiologic; Nifedipine

We present the case of a child who died of pulmonary hypoplasia as a result of the oligohydramnios sequence. The mother was taking enalapril, as well as propranolol and hydrochlorothiazide, for treatment of hypertension associated with systemic lupus erythematosus. Autopsy examination revealed severe renal tubular malformation. Correlation of animal data with previous case reports of neonatal anuria in association with maternal angiotensin converting enzyme inhibitors suggests that these agents may have a deleterious effect on fetal renal development and general well-being.

Topics: Amniotic Fluid; Cerebral Hemorrhage; Cerebral Infarction; Enalapril; Female; Humans; Infant, Newborn; Kidney Glomerulus; Kidney Tubules; Male; Pregnancy; Prenatal Exposure Delayed Effects