The influence of long-term oral administration of enalapril maleate (an an giotensin II-converting enzyme inhibitor) on regional cerebral blood flow (rCBF) was studied in 10 patients with chronic cerebral infarction. The rCBF was meas ured by a 133Xe inhalation method before and after a mean of sixty-five days' administration of 5 mg of enalapril.
Results: Mean arterial blood pressure (MABP) was mildly decreased in 6 pa tients, but the average change in MABP was not significant (Endtidal partial pressure of carbon dioxide (PeCO2) was not changed significantly. The mean rCBF was increased by 8% after administration of enalapril (0.05 < p<0.1) There was no significant correlation between percent change in MABP and the percent change in rCBF. These results indicate that enalapril has not only antihyperten sive action but also a beneficial effect on the cerebral circulation in patients with chronic cerebral infarction.
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References
1.
Johanson JH, Beevers DG, et al: The importance of good blood pressure control in the prevention of stroke recurrence in hypertensive patients. Postgrad Med J57:690-693, 1981.
2.
Brunner HR, Gavras H., Waeber B., et al: Oral angiotensin converting enzyme inhibitor in longterm treatment of hypertensive patients. Ann Int Med90:19-23, 1979.
3.
Groog SH, Levine S., Testa MA: The effects of antihypertensive therapy on the quality of life. N Eng J Med314:1657-1664, 1986.
4.
Bames FM, Barnes NM, Costrall B. et al: ACE inhibition and cognition. In: Current Advances in ACE Inhibition, ed. by MacGregor GA, Sever PS.London: Churchill Livingstone, 1989, pp 159-171.
5.
Yamaguchi T., Minematsu K., Ishihara N., et al: Effects of ACE inhibitor (captopril) on blood pressure and cerebral blood flow in patients with chronic stage cerebrovascular disease: a co-operative study. In: Current Advances in ACE inhibition, ed. by MacGregor GA, Sever PS, London: Churchill Livingstone , 1989, pp 217-221.
6.
Patchett AA, Harris E., Tristram EW, et al: A new class of angiotensin converting enzyme inhibitors. Nature288:280-283, 1980.
7.
Tocco DJ, de Luna FA, Duncan Aew, et al: The physiological disposition and metabolism of enalapril maleate in laboratory animals. Drug Metab Dispos10:15-19, 1982.
8.
Shionoiri H. , Goto E., Akiba N., et al: Blood concentration and effect of enalapril on blood pressure, renin angiotensin system and kallikrein kinin system in patients with essential hypertension. Circulation68 (suppl III)::III-348, 1983.
9.
Schrader F, Schoel, Buhr-Schinner H, et al: Tolerability of enalapril in hypertensives in comparison with other antihypertensives—results of a six month randomized trial. In: Current Advances in ACE inhibition, ed. by MacGregor GA, Sever PS, London: Churchill Livingstone, 1989, pp 223-226.
10.
Frei A., Muller-Brand J.: Cerebral blood flow and hypertensive treatment with enalapril. J Hypertension4:365-367, 1986.
11.
Obrist WD, Thompson HK, Wang HS, et al: Regional cerebral blood flow estimated by Xc133 inhalation. Stroke6:245-256, 1975.
12.
Kobayashi S. , Yamaguchi S., Katsube T., et al: Longterm effect of cilostazol on cerebral blood flow in chronic cerebral infarction. Drug Res35:1193-1197, 1985.
13.
Strandgaard S.: Autoregulation of cerebral circulation in hypertension. Acta Neurol Scand (suppl 66) 57:1-82, 1978.
14.
Barry DI, Paulson OB, Jarden JO, et al: Effect of captopril on cerebral blood flow in normotensive and hypertensive rats. Am J Med76(5B):79-85, 1984.
15.
Paulson OB, Jarden JO, Godtfredsen, et al: Cerebral blood flow in patients with congestive heart failure treated with captopril. Am J Med76(5B):91-95, 1984.
16.
Rajagopalan B., Raine Aeg, Cooper R., et al: Changes in cerebral blood flow in patients with severe congestive heart failure before and after captopril treatment . Am J Med76(5B):86-90, 1984.
17.
Hall C., Morkrid L., Zwetnow NN: Regional cerebral blood flow during acute left ventricular failure in the dog: Effect of converting enzyme inhibition. Eur Surg Res20:373-380, 1988.
18.
Heel RC, Brogden RN, Speight TM, et al: Captopril: A preliminary review of its pharmacological properties and therapeutic efficacy. Drugs20:409-452, 1980.
19.
Landahl S., Lernfelt B.: Cardiac function and cerebral blood flow in elderly hypertensive patients . Nephron55(suppl I):98, 1990.
20.
Yamaguchi S. , Kobayashi S., Katsube T., et al: Effect of diltiazem on regional cerebral blood flow in cerebral infarction. JpnPharmacol Therap11(suppl 1277-284, 1983.
