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September 1, 1980Hypertension

Differences in response to the peptidyldipeptide hydrolase inhibitors SQ 20,881 and SQ 14,225 in normal-renin essential hypertension.

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Why the study?

Does captopril differ from teprotide in vascular and hormonal responses in patients with normal renin essential hypertension?

Population

31 patients with normal renin essential hypertension given a 10 mEq sodium diet

Comparison

Captopril (SQ 14,225) vs Teprotide (SQ 20,881)

Design

Cohort

Authors

FCFrank R. CrantzBrigham and Women's HospitalSSStephen L. SwartzSprint (United States)NHNorman K. HollenbergGeneral / Preventive / Lipids

Discussion

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Implication

Captopril may confer greater BP reduction without kinin elevation in normal-renin hypertension; leaves open mechanistic distinctions pending randomized confirmation.

Key Points

  • To compare the vascular, hormonal, and kinin responses to two peptidyldipeptide hydrolase inhibitors, teprotide (SQ 20,881) and captopril (SQ 14,225), in patients with normal-renin essential hypertension.
  • Studied patients with normal-renin essential hypertension maintained on a 10 mEq sodium diet.
  • Administered either SQ 20,881 (n=10) or SQ 14,225 (n=21) and monitored blood pressure, angiotensin II, plasma renin activity (PRA), and plasma kinin levels.
  • SQ 14,225 produced a significantly greater decrease in diastolic blood pressure (-18 ± 1.5 mm Hg) compared to SQ 20,881 (-13 ± 2.5 mm Hg; p < 0.02).
  • Both SQ 20,881 and SQ 14,225 caused significant, comparable decreases in angiotensin II (-7.1 ± 2.1 pg/ml vs -6.6 ± 1.5 pg/ml; p < 0.01) and increases in PRA (+6.6 ± 1.9 ng/ml/hr vs +7.8 ± 2.4 ng/ml/hr; p < 0.01).
  • Plasma kinins significantly increased after SQ 20,881 (+2.0 ± 0.9 ng/ml, p < 0.01) but showed no change following SQ 14,225 (0.0 ± 0.1 ng/ml, ns).

Structured PICO

Does captopril differ from teprotide in vascular and hormonal responses in patients with normal renin essential hypertension?

P
Population
31 patients with normal renin essential hypertension given a 10 mEq sodium diet
I
Intervention
Captopril (SQ 14,225)
C
Comparator
Teprotide (SQ 20,881)
O
Outcome
Vascular and hormonal responses (diastolic blood pressure, angiotensin II, plasma renin activity, plasma kinins)surrogate

Captopril and teprotide lower blood pressure through different mechanisms in normal renin essential hypertension, with captopril producing a greater hypotensive response without increasing plasma kinins.

Cite This Study

Crantz et al. (1980) studied this question.

synapsesocial.com/papers/6a8bf07d3fd21775a533c8c8https://doi.org/10.1161/01.hyp.2.5.604

Topics

Hypertension management
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