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

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
December 2003
Journal of Gastroenterology;2003, Vol. 38 Issue 12, p1150
Academic Journal
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.


Related Articles

  • Losartan Is Valuable for Patients with Wide Range of Renal Dysfunction. Schulz, E.; Bech, J.; Pedersen, E.B. // Kidney;Nov/Dec2000, Vol. 9 Issue 6, p267 

    Focuses on a study which compared the effects on blood pressure and tolerability of the angiotensin II ATI receptor antagonist losartan and the angiotensin-converting enzyme inhibitor captopril in patients with mild-to-moderate hypertension and impaired renal function. Methodology; Results;...

  • Efficacy and Safety of Imidapril in Patients with Essential Hypertension: A Double-Blind Comparison with Captopril. Kou-Liong Chien, Finn; Ming-Fong Chen; Ling-Ping Lai; Fu-Tien Chiang; Por-Jau Huang, Finn // Cardiology;2001, Vol. 95 Issue 3, p146 

    In this 12-week, double-blind, parallel-group, comparative trial, 57 adult patients with mild-to-moderate hypertension were randomly allocated to receive imidapril or captopril, initially at a dose of 5 mg once a day and 25 mg twice daily, respectively. After 4 weeks of therapy, the dose of each...

  • Effects of Captopril on Cardiac and Renal Damage, and Metabolic Alterations in the Nitric Oxide-Deficient Hypertensive Rat. Khattab, Mahmoud M.; Mostafa, Adel; Al-Shabanah, Othman // Kidney & Blood Pressure Research;2005, Vol. 28 Issue 4, p243 

    Chronic inhibition of nitric oxide (NO) synthesis is characterized by increased blood pressure accompanied with both cardiac hypertrophy as well as renal damage. We investigated whether the angiotensin-converting enzyme (ACE) inhibitor captopril can inhibit the cardiac hypertrophy and reverse...

  • Treatment and management of hypertension: the path is becoming clearer. Dryden, Christine // Nurse Prescribing;Dec2006/Jan2007, Vol. 4 Issue 11, p460 

    Hypertension is often asymptomatic and recoding blood pressure is often opportunistic. A major concern, until recently in primary care has been the disparity between two main guidelines from NICE and the British Hypertension Society. With the growing evidence that beta blockers can increase the...

  • Inhibition of the Cerebral Renin-Angiotensin System to Limit Cognitive Decline in Elderly Hypertensive Persons. Opie, Lionel // Cardiovascular Drugs & Therapy;Aug2011, Vol. 25 Issue 4, p277 

    The author discusses the role of renin-angiotension system (RAS)-inhibitors in the treatment of hypertension in elderly people. A background on several studies showing the benefits of captopril to hypertensive patients is given. The mechanistic data on the role of angiotensin-II (A-II) on...

  • Why is calling an ACE an ACE so controversial? Evaluating reference-based pricing in British Columbia. Anis, Aslam // CMAJ: Canadian Medical Association Journal;3/19/2002, Vol. 166 Issue 6, p763 

    Comments on the practice of reference-based drug pricing for angiotensin-converting enzyme (ACE) inhibitors in British Colombia. Use of population-based data from government prescription drug programs to assess the effects of ACE inhibitors in the treatment of hypertension; Discussion of the...

  • Federal committee calls for revised hypertension staging system.  // Geriatrics;Feb1993, Vol. 48 Issue 2, p70 

    This article focuses on the fifth report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC5) in the U.S. The report, sponsored by the National Heart, Lung and Blood Institute, proposed new guidelines for a revised staging system to define various...

  • Quinapril for Treatment of Hypertension in Turkey. Yener, Gul; Aran, Sinan; Bahceci, Mithat; Ozdemir, Kurtulus; Gultekin, Fusun; Lowe, Wing // Clinical Drug Investigation;2007, Vol. 27 Issue 9, p613 

    BACKGROUND: and objective: Recently the PatenT (Prevalence, awareness, treatment and control of hypertension in Turkey) study showed that while the prevalence of hypertension in Turkey is high, effective control of BP is infrequently achieved. This study investigated the efficacy and safety of...

  • Comparative Effects of a Novel Angiotensin-Converting Enzyme Inhibitor versus Captopril on Plasma Angiotensins after Myocardial Infarction. Flores-Monroy, Jazmín; Ferrario, Carlos M.; Valencia-Hernández, Ignacio; Hernández-Campos, Maria Elena; Martínez-aguilar, Luisa // Pharmacology;Sep2014, Vol. 94 Issue 1/2, p21 

    The compound 4-tert-butyl-2,6-bis(thiomorpholin-4-ylmethyl)phenol (TBTIF) has molecular characteristics similar to angiotensin-converting enzyme (ACE) inhibitors of the sulfhydryl subclass. To assess its value as a new therapeutic agent, we performed a comparative analysis of the effect of TBTIF...


Read the Article


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

Try another library?
Sign out of this library

Other Topics