Skip to main content
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1991 Mar;31(3):305–312. doi: 10.1111/j.1365-2125.1991.tb05534.x

A comparison of the chronic effects of oral xamoterol and enalapril on blood pressure and renal function in mild to moderate heart failure.

M J Jamieson 1, J Webster 1, G Fowler 1, J Rawles 1, F W Smith 1, J C Petrie 1
PMCID: PMC1368357  PMID: 1675867

Abstract

1. We compared the effects, after 3 weeks oral therapy, of xamoterol 200 mg twice daily and enalapril 2.5, 5 or 10 mg twice daily on home and clinic blood pressure, glomerular filtration rate (GFR) and renal plasma flow, stroke and minute distances, linear resistance and on plasma renin activity in 19 patients with mild to moderate heart failure in a single-blind randomised crossover study. 2. Enalapril reduced mean home blood pressure by 17/7 mm Hg compared with xamoterol (P less than 0.0001) and by 19/7 mm Hg compared with placebo. Compared with placebo xamoterol had no effect. Enalapril reduced predose blood pressure, compared with xamoterol, on average by 15/5 mm Hg (P = 0.02 systolic, 0.09 diastolic) and by 20/7 mm Hg compared with placebo. At 4 h post-dose the mean differences were: xamoterol-enalapril 13/10 mm Hg (P = 0.01 systolic, 0.0007 diastolic) and placebo-enalapril 23/9 mm Hg. 3. Stroke and minute distances were marginally less 4 h following xamoterol than following enalapril: mean (s.e. mean) values were 9.4 (0.7) vs 10.4 (0.8) cm (P = 0.23) and 699 (51.7) vs 767 (62.1) cm (P = 0.04) respectively. Linear resistance was reduced by enalapril, from the placebo value of 13.2 (1.2) to 11.0 (0.9) mm Hg m-1 and marginally increased by xamoterol, to 14.2 (1.2) mm Hg m-1, the difference between active treatments being statistically significant (P = 0.03). 4. Renal plasma flow, GFR and filtration fraction were not influenced by enalapril or xamoterol therapy. There were no significant correlations between glomerular filtration rate and either blood pressure or stroke distance.(ABSTRACT TRUNCATED AT 250 WORDS)

Full text

PDF
312

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cleland J. G., Dargie H. J., Ball S. G., Gillen G., Hodsman G. P., Morton J. J., East B. W., Robertson I., Ford I., Robertson J. I. Effects of enalapril in heart failure: a double blind study of effects on exercise performance, renal function, hormones, and metabolic state. Br Heart J. 1985 Sep;54(3):305–312. doi: 10.1136/hrt.54.3.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Creager M. A., Halperin J. L., Bernard D. B., Faxon D. P., Melidossian C. D., Gavras H., Ryan T. J. Acute regional circulatory and renal hemodynamic effects of converting-enzyme inhibition in patients with congestive heart failure. Circulation. 1981 Sep;64(3):483–489. doi: 10.1161/01.cir.64.3.483. [DOI] [PubMed] [Google Scholar]
  3. Cruickshank J. M., Thorp J. M., Zacharias F. J. Benefits and potential harm of lowering high blood pressure. Lancet. 1987 Mar 14;1(8533):581–584. doi: 10.1016/s0140-6736(87)90231-5. [DOI] [PubMed] [Google Scholar]
  4. Daniel M. K., Bennett B., Dawson A. A., Rawles J. M. Haemoglobin concentration and linear cardiac output, peripheral resistance, and oxygen transport. Br Med J (Clin Res Ed) 1986 Apr 5;292(6525):923–926. doi: 10.1136/bmj.292.6525.923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dzau V. J., Colucci W. S., Williams G. H., Curfman G., Meggs L., Hollenberg N. K. Sustained effectiveness of converting-enzyme inhibition in patients with severe congestive heart failure. N Engl J Med. 1980 Jun 19;302(25):1373–1379. doi: 10.1056/NEJM198006193022501. [DOI] [PubMed] [Google Scholar]
  6. Dzau V. J., Hollenberg N. K. Renal response to captopril in severe heart failure: role of furosemide in natriuresis and reversal of hyponatremia. Ann Intern Med. 1984 Jun;100(6):777–782. doi: 10.7326/0003-4819-100-6-777. [DOI] [PubMed] [Google Scholar]
  7. Gallacher J. E., Yarnell J. W., Rogers S., Sweetnam P. Automatic measurement of blood pressure: evaluation of the Copal UA-231 automatic sphygmomanometer. J Epidemiol Community Health. 1985 Sep;39(3):220–223. doi: 10.1136/jech.39.3.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ichikawa I., Pfeffer J. M., Pfeffer M. A., Hostetter T. H., Brenner B. M. Role of angiotensin II in the altered renal function of congestive heart failure. Circ Res. 1984 Nov;55(5):669–675. doi: 10.1161/01.res.55.5.669. [DOI] [PubMed] [Google Scholar]
  9. Jennings G., Bobik A., Oddie C., Restall R. Cardioselectivity, kinetics, hemodynamics, and metabolic effects of xamoterol. Clin Pharmacol Ther. 1984 May;35(5):594–603. doi: 10.1038/clpt.1984.82. [DOI] [PubMed] [Google Scholar]
  10. Kubo S., Nishioka A., Nishimura H., Kawamura K., Takatsu T. Effects of captopril on arterial and venous pressure, renal function, and humoral factors in severe chronic congestive heart failure. Clin Pharmacol Ther. 1984 Oct;36(4):456–463. doi: 10.1038/clpt.1984.204. [DOI] [PubMed] [Google Scholar]
  11. Malatino L. S., Brown W. C. Comparison of a new portable electronic sphygmomanometer (Copal UA251) with the Hawksley random zero machine. Clin Exp Hypertens A. 1988;10(4):589–596. doi: 10.3109/10641968809033911. [DOI] [PubMed] [Google Scholar]
  12. Marlow H. F. Xamoterol, a beta 1-adrenoceptor partial agonist: review of the clinical efficacy in heart failure. Br J Clin Pharmacol. 1989;28 (Suppl 1):23S–30S. doi: 10.1111/j.1365-2125.1989.tb03570.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Metcalfe M. J., Rawles J. M. Stroke distance in acute myocardial infarction: a simple measurement of left ventricular function. Lancet. 1989 Jun 17;1(8651):1371–1373. doi: 10.1016/s0140-6736(89)92814-6. [DOI] [PubMed] [Google Scholar]
  14. Packer M., Lee W. H., Kessler P. D. Preservation of glomerular filtration rate in human heart failure by activation of the renin-angiotensin system. Circulation. 1986 Oct;74(4):766–774. doi: 10.1161/01.cir.74.4.766. [DOI] [PubMed] [Google Scholar]
  15. Packer M., Lee W. H., Medina N., Yushak M., Kessler P. D. Functional renal insufficiency during long-term therapy with captopril and enalapril in severe chronic heart failure. Ann Intern Med. 1987 Mar;106(3):346–354. doi: 10.7326/0003-4819-106-3-346. [DOI] [PubMed] [Google Scholar]
  16. Pierpont G. L., Francis G. S., Cohn J. N. Effect of captopril on renal function in patients with congestive heart failure. Br Heart J. 1981 Nov;46(5):522–527. doi: 10.1136/hrt.46.5.522. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Powers E. R., Bannerman K. S., Stone J., Reison D. S., Escala E. L., Kalischer A., Weiss M. B., Sciacca R. R., Cannon P. J. The effect of captopril on renal, coronary, and systemic hemodynamics in patients with severe congestive heart failure. Am Heart J. 1982 Nov;104(5 Pt 2):1203–1210. doi: 10.1016/0002-8703(82)90052-7. [DOI] [PubMed] [Google Scholar]
  18. Virk S. J., Davies M. K. Effects of xamoterol on resting and exercise haemodynamics in patients with chronic heart failure. Br J Clin Pharmacol. 1989;28 (Suppl 1):15S–22S. [PMC free article] [PubMed] [Google Scholar]
  19. Zech P. Y., Pozet N., Day M. A., Snow H. M., Madonna O., Hadj-Aissa A. Effects of xamoterol on sodium excretion in volunteers. Br J Clin Pharmacol. 1989;28 (Suppl 1):89S–91S. doi: 10.1111/j.1365-2125.1989.tb03584.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES