MECHANISMS OF COMBINED ACTION OF ACE INHIBITORS AND CALCIUM ANTAGONISTS IN ARTERIAL HYPERTENSION
https://doi.org/10.15829/1728-8800-2013-3-72-77
Abstract
This review presents the modern views on the effectiveness of water-soluble angiotensin-converting enzyme (ACE) antagonists and calcium antagonists (CA), as monotherapy or as fixed-dose combination therapy, in the treatment of arterial hypertension (AH). The results of the X-ray structural analysis of crystal ACE-lisinopril complexes suggest a highly selective, strong inhibitory effect of lisinopril on various ACE forms of the hormonal renin-angiotensin-aldosterone system and tissue renin-angiotensin systems. The association between specific action mechanisms and therapeutic effects in hypertension is analysed for a third-generation CA amlodipine. The benefits of a fixed-dose combination medication Ekvator (amlodipine 5 mg plus lisinopril 10 mg) in hypertension are described, including its synergetic protective effects.
About the Authors
E. I. Astashkin
I. M. Sechenov First Moscow State Medical University, Moscow
Russian Federation
tel.: (916) 062–05–30
Russian Federation
tel.: (916) 062–05–30
M. G. Glezer
I. M. Sechenov First Moscow State Medical University, Moscow
Russian Federation
Russian Federation
References
1. Jamerson K, Weber MA, Bakris GL, ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359 (23): 2417–28.
2. Neutel JM, Smith DH, Weber MA. Low-dose combination therapy: an important first-line treatment in the management of hypertension. Am J Hypertens 2001; 14 (3): 286–92.
3. Glezer M, Avakian A. Resistant hypertension. Ways to overcome. Problems of women’s health 2012; 7 (1): 29–46. Russian (Глезер М. Г., Авакян А. А. Резистентная артериальная гипертензия. Пути преодоления проблемы. Проблемы женского здоровья 2012; 7 (1): 29–46).
4. Oliveira L, Costa-Neto C, Nakaie C, et al. The Angiotensin II AT1 Receptor Structure-Activity Correlation in the Light of Rhodopsin Structure. Physiol. Rev 2007; 87: 565–92.
5. Fyhrquist F, Saijonmaa O. Renin-angiotensin system revisited. J Internal Medicine 2008; 264 (3): 224–36.
6. Astashkin EI, Glaser MG. New data on the functioning of the renin-angiotensin system: the role of intracellular (intrakrine) system. Problems of Women’s Health 2012, 7 (1): 47–54. Russian (Асташкин Е. И., Глезер М. Г. Новые данные о функционировании ренин-ангиотензиновой системы: роль внутриклеточной (интракринной) системы. Проблемы женского здоровья 2012; 7 (1): 47–54).
7. Mehta P, Griendling K. Angiotensin II cell signaling: physiological and pathological effects in cardiovascular system Am J Physiol (Cell Physiol) 2007; 292: C 82–97.
8. Opie LH. Angiotensin converting enzyme. NY 1999; 274 p.
9. Sarzani R, Salvi F, Dessi-Fulgheri P, et al. Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome and hypertension: an integrated view in humans. J Hypertens 2008; 26: 831–43.
10. Fleming I, Kohlstedt K, Busse R. The tissue renin-angiotensin system and intracellular signalling. Curr Opin Nephrol Hypertens 2006; 15: 8–13.
11. Paul M, Poyan Mehr A, Kreutz R. Physiology of local renin-angiotensin systems. Physiol Rev 2006; 86: 747–803.
12. Leung PS. The physiology of a local renin-angiotensin system in the pancreas. J Physiol 2007; 580: 31–7.
13. Nguyen G, Delarue F, Burckle C, et al. Pivotal role of the renin/prorenin receptor in angiotensin II production and cellular responses to renin. J Clin Invest 2002; 109: 1417–27.
14. Kumar R, Singh VP, Baker KM. The intracellular renin-angiotensin system: a new paradigm Trends Endocrino. Metab 2007; 18: 208–14.
15. De Mello WC. Cardiac intracrine renin angiotensin system. Part of genetic reprogramming? Regul Pept 2006; 133: 10–2.
16. Re RN, Cook JL. The intracrine hypothesis: an update. Regul Pept 2006; 133: 1–9.
17. Baker KM, Chernin MI, Schreiber T, et al. Evidence of a novel intracrine mechanism in angiotensin II-induced cardiac hypertrophy. Regul Pept 2004; 120: 5–13.
18. Natesh R, Schwager SLU, Sturrock ED, Acharya KR. Crystal structure of the human angiotensin-converting enzyme–lisinopril complex. Nature 2003; 421: 551–4.
19. Sturrock ED, Natesh R, van Rooyen JM, Acharya KR. Structure of angiotensin I — converting enzyme. Cell Mol Life Sci 2004; 61 (21): 2677–86.
20. Fernandez JH, Hayashi MAF, Camargo ACM, Neshich G. Strucural basis of the lisinopril-binding specificyty in N- and C-damains of human somatic ACE. Biochem Biophys Res Communic 2003; 308: 219–26.
21. Astashkin EI, Glezer MG Effect of lisinopril on the hormonal and tissue RAS. Physician 2009; 7: 1–6. Russian (Асташкин Е. И., Глезер М. Г. Влияние лизиноприла на гормональные и тканевые РАС. Врач 2009; 7: 1–6).
22. Rizzoni D, Muiesan ML, Porteri E, et al. Effects of long-term antihypertensive treatment with lisinopril on resistance arteries in hypertensive patients with left ventricular hypertrophy. J Hypertens 1997; 15 (2): 197–204.
23. Brilla CG, Funck RC, Rupp H. Lisinopril-Mediated Regression of Myocardial Fibrosis in Patients With Hypertensive Heart Disease. Circulation 2000; 102 (12): 1388–93.
24. Geiger H, Fierlbeck W, Mai M, et al. Effects of early and late antihypertensive treatment on extracellular matrix proteins and mononuclear cells in uninephrectomized SHR. Kidney Int 1997; 51 (3): 750–61.
25. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288 (23): 2981–97.
26. Reisin E, Weir M, Falkner B, et al. Treatment in Obese Patients With Hypertensive; (TROPHY) Study Group Lisinopril Versus Hydrochlorothiazide in Obese Hypertensive Patients A Multicenter Placebo Controlled Trial Hypertension 1997; 30: 140–5.
27. Glezer MG, Boiko, NV, Abildinova AZ Improved structural and functional cardio-vascular system in the prevention of heart failure antihypertensive therapy with ACE inhibitors. Abstracts. ”Heart failure”, Moscow, 13–14 December 2001. Russian (Глезер М. Г., Бойко Н. В., Абильдинова А. Ж. Улучшение структурно-функциональных показателей сердечно-сосудистой системы в профилактике сердечной недостаточности на фоне антигипертензивной терапии ингибиторами АПФ. Тезисы докладов. «Сердечная недостаточность», М., 13–14 декабря 2001).
28. The EUCLID Study Group. Randomised placebo-controlled trial of lisinopril in normotensive patients with insulin-dependent diabetes and normoalbumiuria or microalbuminuria. Lancet 1997; 349: 1787–92.
29. GISSI-3 Invesrigators. Effect of Lisinopril Treatment on Early Mortality in Patients With Acute Myocardial Infarction at Different Risk Profile: Data From The GISSI-3 Study. JACC 1999; 82A: poster 902–35.
30. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet 1994; 343: 1115–22.
31. Packer M, Poole-Wilson P, Armstrong P, et al. Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. Circulation 1999; 100: 2312–8.
32. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004; 363: 2022–31.
33. Dahl f B, Sever PS, Poulter NR, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo- Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895–906.
34. Naidu MU, Usha PR, Rao TR, Shobha JC. Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension. Postgrad Med J 2000; 76 (896): 350–3.
35. Cappuccio FP, Markandu ND, Singer RR, MacGregor GA. Amlodipine and lisinopril in combination for the treatment of essential hypertension: efficacy and predictors of response. J Hypertens 1993; 11 (8): 839–47.
Review
For citations:
Astashkin E.I., Glezer M.G. MECHANISMS OF COMBINED ACTION OF ACE INHIBITORS AND CALCIUM ANTAGONISTS IN ARTERIAL HYPERTENSION. Cardiovascular Therapy and Prevention. 2013;12(3):72-77. (In Russ.) https://doi.org/10.15829/1728-8800-2013-3-72-77
Views:
1284
Email this article 
