viprostol and Hypertension

Endogenous prostaglandin E2 appears to play an important role in cardiovascular homeostasis. When administered exogenously, it is a potent vasodilator, but the requirement for intravenous administration and its short duration of action have limited studies to its acute effects. A novel prostaglandin E2 analogue, CL 115347, can be administered transdermally on a long-term basis. The cardiovascular responses to the chronic administration of CL 115347 were studied in a double-blind, placebo-controlled trial in 26 subjects with essential hypertension (16 given drug, 10 placebo) maintained on a 100-mEq sodium diet. Administration of CL 115347 produced a fall in diastolic blood pressure of 7.8 +/- 1.3 mm Hg, compared with a 2.3 +/- 1.7 mm Hg fall in controls (p = 0.02), with no change in heart rate. The direct vascular effect of the drug was confirmed by attenuation of the vasoconstrictor response to angiotensin II infusion (13.4 +/- 3.1 vs 21 +/- 2 mm Hg at 3.0 ng/kg/min; p less than 0.05). However, the chronic blood pressure effect of CL 115347 was modest. Subjects receiving active drug showed significant compensatory increases in plasma renin, aldosterone, and norepinephrine levels accompanied by sodium retention and kaliuresis. In summary, chronic administration of this prostaglandin E2 analogue resulted in a modest decrease in blood pressure and antagonism of angiotensin II-mediated vasoconstriction. However, its effects were largely offset by compensatory increases in vasoconstrictor hormones and sodium retention.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aldosterone; Antihypertensive Agents; Blood Pressure; Clinical Trials as Topic; Dinoprostone; Double-Blind Method; Female; Heart Rate; Humans; Hypertension; Male; Middle Aged; Natriuresis; Norepinephrine; Prostaglandins E, Synthetic; Renin; Sodium

Topics: Administration, Cutaneous; Administration, Oral; Animals; Antihypertensive Agents; Blood Pressure; Dinoprostone; Epoprostenol; Hypertension; Rats; Rats, Inbred SHR

CL 115,347 orally (0.25-10 mg/kg) and topically (0.03 and 0.1 mg/kg) lowered blood pressure in a dose-dependent manner in conscious spontaneously hypertensive rats (SHR). Duration of action of the oral dose range was from 1 to more than 8 h and of the topical dose range, from more than 6 to more than 24 h. CL 115,347 was 100-200 times more potent orally and greater than 250 times more potent topically than l-prostaglandin (PG) E2. When 3 mg/kg was administered orally, CL 115,347 was also active in Dahl "S" salt-sensitive hypertensive rats, deoxycorticosterone acetate-salt hypertensive rats, aorta-coarcted renin-dependent hypertensive rats, normotensive rats, bilaterally nephrectomized SHR, and bilaterally ureteral-ligated SHR. CL 115,347 was also orally active at 0.1 mg/kg in normotensive rhesus monkeys and in renal hypertensive dogs at 1 mg/kg. CL 115,347 was as active as l-PGE2 in relaxing the rabbit ear arterial smooth muscle in vitro. In anesthetized dogs, CL 115,347 injected intra-arterially (0.5-10 micrograms) into the vascular bed being studied increased blood flow to femoral, carotid, coronary, superior mesenteric, and renal vascular beds. CL 115,347 decreased vasopressor responses induced by electrical stimulation of the spinal cord at T7-T9 but did not decrease the tachycardia induced by stimulation of the cardioaccelerator segments (C7-T1) in pithed SHR. CL 115,347 has a broad spectrum of antihypertensive activity in various animal models and probably exerts its major antihypertensive effects through relaxation of blood vessels.

Topics: Administration, Oral; Administration, Topical; Animals; Antihypertensive Agents; Dinoprostone; Dogs; Hypertension; Prostaglandins E; Prostaglandins E, Synthetic; Rabbits; Rats; Rats, Inbred Strains; Regional Blood Flow; Vasodilation