spirapril and Metabolic-Syndrome

To study effects of two hypotensive drugs--normodipin and spirapril--on intravascular activity of platelets in patients with metabolic syndrome (MS).. Normodipin was given to 25 patients with MS for 3 months, spirapril--to 20 patients for 3 months. The effect was evaluated by changes in lipid peroxidation in plasm and platelets, antioxidant defense of liquid blood and platelets, intravascular activity of platelets.. Administration of normodipin in MS patients had a positive effect on lipid peroxidation and normalized intravascular activity of platelets. Such pronounced positive effects on lipid peroxidation of plasm and platelets as well as on intravascular activity of the latter were not registered after use of spirapril.. Optimization of platelet function in MS patients can be achieved with long-term normodipin treatment.

Topics: Adult; Amlodipine; Antihypertensive Agents; Blood Platelets; Blood Pressure; Enalapril; Female; Humans; Lipid Peroxidation; Male; Metabolic Syndrome; Middle Aged; Platelet Activation; Venous Thrombosis

Achievement of target blood pressure (BP) levels in subjects with metabolic syndrome (MS) by the method of stepwise antihypertensive therapy and assessment of metabolic effects of combination of spirapril and nifedipine retard.. Patients (n=20, 12 women, 8 men, mean age 54+/-3 years) with MS were first given spirapril (6 mg/day). Nifedipine retard (40 mg/day) was added if target BP was not achieved after 4 weeks. Study duration was 12 weeks. The following parameters were measured at baseline and at study end: heart rate, blood pressure, body mass, waist circumference, parameters of lipid spectrum, content of insulin including index HOMA IR, blood glucose (fasting and during oral glucose tolerance test).. Target BP levels were achieved in 18 patients (90%)--in 11 with moexipril monotherapy, in 9--after addition of nifedipine. Lowering of systolic and diastolic BP from baseline was 11 and 14%, respectively. After 3 months of combination antihypertensive therapy triglyceride levels decreased by 28% while high density lipoprotein cholesterol (CH) increased 6%. Total, low density lipoprotein CH and coefficient of atherogenecity did not change as well as fasting blood glucose after fast and oral glucose tolerance test. Concentration of fasting immunoreactive insulin significantly decreased by 34% entailing 35% decrease of insulin resistance. Therapy was well tolerated, side effects were transitory and did not cause withdrawal of treatment.. In patients with MS and mild hypertension monotherapy with spirapril and combination of spirapril with nifedipine retard caused lowering of BP to target level in 55 and 90%, respectively. Combination of spirapril and nifedipine retard exerts positive metabolic action.

Topics: Adult; Angiotensin-Converting Enzyme Inhibitors; Calcium Channel Blockers; Cholesterol, LDL; Drug Therapy, Combination; Enalapril; Female; Glucose Intolerance; Humans; Hypertension; Male; Metabolic Syndrome; Middle Aged; Nifedipine; Severity of Illness Index

Moexipril (7.4-15 mg/day) was given to 34, spirapril (3-6 mg/day) -- to 18 postmenopausal women with hypertension and metabolic syndrome for 16 weeks. Hydrochlorthiazide was added when therapy was not sufficiently effective. Both angiotensin converting enzyme inhibitors had similar hypotensive activity: blood pressure normalized in 71 and 61% of moexipril and spirapril treated women, respectively. Both drugs promoted normalization of metabolism of lipid (lowering of levels of cholesterol, atherogenic lipoproteins and triglycerides) and carbohydrates (lowering of hyperinsulinemia). Patients with postmenopausal metabolic syndrome had elevation of leptin level up to 27.5+/-5.5 pg/ml. Moexipril and spirapril caused lowering of elevated levels of leptin. These drugs did not affect levels of sex hormones. They exerted vasoprotective (normalization of endothelium dependent and independent vasodilatation) and nephroprotective (attenuation and normalization of microalbuminuria) effects. Thus spirapril and moexipril are effective in treatment of hypertension in patients with postmenopausal metabolic syndrome.

Topics: Angiotensin-Converting Enzyme Inhibitors; Blood Pressure; Drug Therapy, Combination; Enalapril; Female; Follow-Up Studies; Humans; Hypertension; Lipids; Metabolic Syndrome; Middle Aged; Postmenopause; Tetrahydroisoquinolines; Treatment Outcome