TITLE

Captopril reduces portal pressure effectively in portal hypertensive patients with low portal venous velocity

AUTHOR(S)
Baik, Soon Koo; Park, Dong Hun; Kim, Moon Young; Choi, Yeun Jong; Kim, Hyun Soo; Lee, Dong Ki; Kwon, Sang Ok; Kim, Young Ju; Park, Joong Wha; Chang, Sei Jin
PUB. DATE
December 2003
SOURCE
Journal of Gastroenterology;2003, Vol. 38 Issue 12, p1150
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background Methods. The hepatic venous pressure gradient (HVPG) and portal venous velocity (PVV) were measured both before and 3 months after initiation of the administration of captopril (n = 29) or propranolol (n = 29) in cirrhotic patients with a variceal bleeding episode. Patients who showed a reduction in the HVPG of more than 20% of the baseline were defined as being responders. Results. At 3 months, the mean reduction in the HVPG after captopril was less than that after propranolol (-3.0 ± 9.3% vs -28.5% ± 4.1%; P ≪ 0.05). However, of the 29 patients receiving captopril, 9 were classified as being responders. On multivariate analysis with parameters including age, cause, Child-Pugh score, HVPG, and PVV, only low PVV was found to be a significant independent factor for responders (PVV ≪ 12 cm/s; odds ratio [OR], 12.2; 95% confidence interval [CI], 1.47–102.40) in the captopril group. Conclusions. Longterm captopril administration reduces the portal pressure effectively in cirrhotic patients with a low PVV. This suggests that the reduction in portal pressure after captopril administration is a result of improved portal venous outflow brought about by a decrease in the intrahepatic vascular resistance. When the PVV is below 12 cm/s, a captopril trial might be useful in preventing variceal bleeding in portal hypertensive patients. The effect of an angiotensin II blockade in lowering the portal pressure in patients with liver cirrhosis and portal hypertension is controversial. This prospective study was undertaken to evaluate the portal hypotensive effect of captopril compared to that of propranolol, and to determine the factors that contribute to a successful reduction in the portal pressure after longterm captopril administration in patients with liver cirrhosis.
ACCESSION #
11901309

 

Related Articles

  • Therapeutic advantages of angiotensin converting enzyme inhibitors in chronic renal disease. OMATA, KEN; KANAZAWA, MASAYUKI; SATO, TATSUYUKI; ABE, FUMIAKI; SAITO, TAKAO; ABE, KEISHI // Kidney International Supplement;Jun1996, Issue 55, pS-57 

    More than other drugs, angiotension converting enzyme (ACE) inhibitors have been shown 10 provide better control of glomerular hypertension and improved preservation of renal function. Long-term treatment with captopril slows the progression of renal impairment in diabetic nephropathy; however,...

  • Preventive effects of the angiotensin-converting enzyme inhibitor, captopril, on the development of azoxymethane-induced colonic preneoplastic lesions in diabetic and hypertensive rats. TAKAHIRO KOCHI; MASAHITO SHIMIZU; TOMOHIKO OHNO; ATSUSHI BABA; TAKAFUMI SUMI; MASAYA KUBOTA; YOHEI SHIRAKAMI; HISASHI TSURUMI; TAKUJI TANAKA; HISATAKA MORIWAKI // Oncology Letters;2014, Vol. 8 Issue 1, p223 

    Metabolic syndrome (Mets), including diabetes and hypertension, increases the risk of colorectal cancer via the induction of chronic inflammation, acceleration of oxidative stress, and activation of the renin‑angiotensin system. The present study examined the possible inhibitory effects...

  • Captopril and Hydrochlorothiazide.  // AHFS Consumer Medication Information;Mar2019, p1 

    The combination of captopril and hydrochlorothiazide is used to treat high blood pressure. Captopril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly....

  • The Relation of Cirrhosis of the Liver to Renal Hypertension. Schwartz, David T. // Annals of Internal Medicine;May67, Vol. 66 Issue 5, p862 

    Investigates the incidence and course of hypertension in patients with cirrhosis of the liver and the factors associated with changes in blood pressure. Clinical features of patients who are classified as hypertensive; Correlation between the course of arterial blood pressure and the...

  • Captopril in the Treatment of Hypertension. Gavras, Haralambos; Brunner, Hans R.; Gavras, Irene // Annals of Internal Medicine;Oct81, Vol. 95 Issue 4, p505 

    Editorial. Comments on the use of captopril in the treatment of hypertension. Therapy for the inhibition of the angiotensin-converting enzyme; Approaches for the management of hypertension; Mechanisms of action of captopril.

  • Renin-Guided Treatment of Hypertension: Time for Action. Furberg, Curt D. // American Journal of Hypertension;Sep2010, Vol. 23 Issue 9, p929 

    The author reflects on the treatment of hypertension using Laragh and colleagues study as a guide. According to the author, Laragh and colleagues found out that there are four major types of hypertension including low-renin, medium/high-renin, and resistant hypertension. He says that rennin...

  • Highlights.  // American Journal of Hypertension;May2011, Vol. 24 Issue 5, p503 

    The article offers information on the research studies related to the therapeutic efficacy of angiotensins in patients with hypertension and early onset-diabetes. A randomized meta-analysis study of renin inhibitor aliskiren and angiotensin receptor blocker (ARB) in blood pressure is presented....

  • Neutrophil hypersegmentation in children receiving angiotensin converting enzyme inhibitors. Okutan, Vedat; Kürekçi, A. Emin; Sarıcı, S. Ümit; Atay, A. Avni; Yozgat, Yılmaz; Azık, Fatih; Lenk, M. Koray; Özcan, Okan // Turkish Journal of Pediatrics;2008, Vol. 50 Issue 6, p438 

    Captopril and enalapril are the most commonly used angiotensin converting enzyme inhibitors in several cardiac diseases in children. On the other hand, the intrinsic renin-angiotensin system in the bone marrow might affect the growth of hematopoietic colonies and cellular production,...

  • Effects of TIPS on Portal Hemodynamics and Coagulation Function in Patients with Cirrhosis Portal Hypertension. LI Wei-hua; HE Hai-yu; LI Ying; ZHAO Zhen // Journal of Kunming Medical University / Kunming Yike Daxue Xueba;2014, Vol. 35 Issue 8, p83 

    Objective To observe the effects of TIPS on portal hemodynamics and coagulation function in patients with cirrhosis portal hypertension. Methods 30 patients with cirrhosis and portal hypertension who received TIPS, were given routine blood cell analysis, coagulation tests and Color Doppler...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics