Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1982 Sep;48(3):272–277. doi: 10.1136/hrt.48.3.272

Captopril as treatment for patients with pulmonary hypertension. Problem of variability in assessing chronic drug treatment.

S Rich, J Martinez, W Lam, K M Rosen
PMCID: PMC481241  PMID: 7049203

Abstract

We gave captopril, an angiotensin converting-enzyme inhibitor, to four patients with unexplained pulmonary hypertension to see if it would lower pulmonary arterial pressure or pulmonary vascular resistance. The patients were studied at rest and during supine bicycle exercise, before and after 48 hours of captopril treatment (up to 450 mg/day). During the treatment, each patient was monitored, with systemic and pulmonary pressures measured hourly, and cardiac output every two to four hours. We found no significant effect of captopril, either at rest or with exercise, on the cardiac output, pulmonary artery pressure, or pulmonary vascular resistance, measured at the end of 48 hours treatment. We noted, however, that during the 48 hour period, all patients showed pronounced swings in their pulmonary and systemic artery pressures and cardiac outputs that had no relation to the administration of captopril or time of day. We conclude that captopril appears to be ineffective in causing a sustained reduction in the pulmonary artery pressure or pulmonary vascular resistance in patients with primary pulmonary hypertension. It appears, however, that these patients experience spontaneous variability in their pulmonary resistance from hour to hour which needs to be further studied before a reliable assessment of long-term drug treatment can be made.

Full text

PDF
272

Selected References

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

  1. Brunner H. R., Gavras H., Waeber B., Kershaw G. R., Turini G. A., Vukovich R. A., McKinstry D. N., Gavras I. Oral angiotensin-converting enzyme inhibitor in long-term treatment of hypertensive patients. Ann Intern Med. 1979 Jan;90(1):19–23. doi: 10.7326/0003-4819-90-1-19. [DOI] [PubMed] [Google Scholar]
  2. Camerini F., Alberti E., Klugmann S., Salvi A. Primary pulmonary hypertension: effects of nifedipine. Br Heart J. 1980 Sep;44(3):352–356. doi: 10.1136/hrt.44.3.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Davis R., Ribner H. S., Keung E., Sonnenblick E. H., LeJemtel T. H. Treatment of chronic congestive heart failure with captopril, an oral inhibitor of angiotensin-converting enzyme. N Engl J Med. 1979 Jul 19;301(3):117–121. doi: 10.1056/NEJM197907193010301. [DOI] [PubMed] [Google Scholar]
  4. Erdös E. G. Conversion of angiotensin I to angiotensin II. Am J Med. 1976 May 31;60(6):749–759. doi: 10.1016/0002-9343(76)90889-5. [DOI] [PubMed] [Google Scholar]
  5. Ferguson R. K., Vlasses P. H., Koplin J. R., Shirinian A., Burke J. F., Jr, Alexander J. C. Captopril in severe treatment-resistant hypertension. Am Heart J. 1980 May;99(5):579–585. doi: 10.1016/0002-8703(80)90730-9. [DOI] [PubMed] [Google Scholar]
  6. Gavras H., Brunner H. R., Turini G. A., Kershaw G. R., Tifft C. P., Cuttelod S., Gavras I., Vukovich R. A., McKinstry D. N. Antihypertensive effect of the oral angiotensin converting-enzyme inhibitor SQ 14225 in man. N Engl J Med. 1978 May 4;298(18):991–995. doi: 10.1056/NEJM197805042981803. [DOI] [PubMed] [Google Scholar]
  7. Levine T. B., Franciosa J. A., Cohn J. N. Acute and long-term response to an oral converting-enzyme inhibitor, captopril, in congestive heart failure. Circulation. 1980 Jul;62(1):35–41. doi: 10.1161/01.cir.62.1.35. [DOI] [PubMed] [Google Scholar]
  8. Niarchos A. P., Roberts A. J., Laragh J. H. Effects of the converting enzyme inhibitor (SQ 20881) on the pulmonary circulation in man. Am J Med. 1979 Nov;67(5):785–791. doi: 10.1016/0002-9343(79)90735-6. [DOI] [PubMed] [Google Scholar]
  9. Reeves J. T. Hope in primary pulmonary hypertension. N Engl J Med. 1980 Jan 10;302(2):112–113. doi: 10.1056/NEJM198001103020210. [DOI] [PubMed] [Google Scholar]
  10. Rubin B., Antonaccio M. J., Horovitz Z. P. Captopril (SQ 14,225) (D-3-mercapto-2-methylpropranoyl-L-proline): a novel orally active inhibitor of angiotensin-converting enzyme and antihypertensive agent. Prog Cardiovasc Dis. 1978 Nov-Dec;21(3):183–194. doi: 10.1016/0033-0620(78)90024-5. [DOI] [PubMed] [Google Scholar]
  11. Ruskin J. N., Hutter A. M., Jr Primary pulmonary hypertension treated with oral phentolamine. Ann Intern Med. 1979 May;90(5):772–774. doi: 10.7326/0003-4819-90-5-772. [DOI] [PubMed] [Google Scholar]
  12. Shettigar U. R., Hultgren H. N., Specter M., Martin R., Davies D. H. Primary pulmonary hypertension favorable effect of isoproterenol. N Engl J Med. 1976 Dec 16;295(25):1414–1415. doi: 10.1056/NEJM197612162952506. [DOI] [PubMed] [Google Scholar]
  13. Swartz S. L., Williams G. H., Hollenberg N. K., Levine L., Dluhy R. G., Moore T. J. Captopril-induced changes in prostaglandin production: relationship to vascular responses in normal man. J Clin Invest. 1980 Jun;65(6):1257–1264. doi: 10.1172/JCI109788. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES