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Xia T, Xu L, Guo P, Shi W, Cheng Y, Liu A. Synergism of amlodipine and telmisartan or candesartan on blood pressure reduction by using SynergyFinder 3.0 and probability sum test in vivo. Pharmacol Res Perspect 2023; 11:e01064. [PMID: 36810974 PMCID: PMC9944853 DOI: 10.1002/prp2.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023] Open
Abstract
This study was designed to evaluate the synergism of two couples of antihypertensive drugs (amlodipine + telmisartan and amlodipine + candesartan) on blood pressure reduction in vivo by both SynergyFinder 3.0 and probability sum test. Spontaneously hypertensive rats were treated with intragastric administration of amlodipine (0.5, 1, 2, and 4 mg/kg), telmisartan (4, 8, and 16 mg/kg), candesartan (1, 2, and 4 mg/kg), nine combinations for amlodipine and telmisartan, and nine combinations for amlodipine and candesartan. The control rats were treated by 0.5% carboxymethylcellulose sodium. Blood pressure was recorded continuously up to 6 h after administration. Both SynergyFinder 3.0 and the probability sum test were used to evaluate the synergistic action. The synergisms calculated by SynergyFinder 3.0 are consistent with the probability sum test both in two different combinations. There is an obviously synergistic interaction between amlodipine and telmisartan or candesartan. The combinations of amlodipine and telmisartan (2 + 4 and 1 + 4 mg/kg) and amlodipine and candesartan (0.5 + 4 and 2 + 1 mg/kg) might exert an optimum synergism against hypertension. Compared with the probability sum test, SynergyFinder 3.0 is more stable and reliable to analyze the synergism.
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Affiliation(s)
- Tian Xia
- Department of Pharmacology, School of PharmacyNaval Medical UniversityShanghaiChina
- Institute of PharmacyYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lu‐Lu Xu
- Department of Pharmacology, School of PharmacyNaval Medical UniversityShanghaiChina
- Institute of PharmacyYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Peng‐Yue Guo
- Department of Clinical PharmacyNaval Medical UniversityShanghaiChina
| | - Wan‐Ting Shi
- Department of Pharmacology, School of PharmacyNaval Medical UniversityShanghaiChina
- Institute of PharmacyYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Yan‐Qiong Cheng
- Department of Pharmacology, School of PharmacyNaval Medical UniversityShanghaiChina
- Institute of PharmacyYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Ai‐Jun Liu
- Department of Pharmacology, School of PharmacyNaval Medical UniversityShanghaiChina
- Institute of PharmacyYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
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El Mously DA, Mostafa NM, Hassan NY, El-Sayed GM. Different Approaches in Manipulating Ratio Spectra for Analyzing Amlodipine Besylate and Irbesartan Combination. J AOAC Int 2022; 105:1219-1227. [DOI: 10.1093/jaoacint/qsac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/29/2022] [Accepted: 05/25/2022] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Hypertension is a key risk factor for ischemic heart disease and atherosclerosis. Most patients require a combination of antihypertensive medications to accomplish their therapeutic goals. Antihypertensive medicines such as calcium channel blockers and angiotensin receptor blockers are indicated for patients whose high blood pressure cannot be controlled with monotherapy. The combination of amlodipine besylate (AML) with irbesartan (IRB) is an example of this synergistic activity in lowering blood pressure.
Objective
In this regard, the goal of the research is to develop sensitive spectrophotometric methods for the simultaneous determination of amlodipine besylate and irbesartan.
Methods
Three simple ratio spectra-manipulating spectrophotometric methods namely, ratio difference, mean centering of ratio spectra, and derivative ratio, were developed for the simultaneous assay of the cited mixture.
Results
Linear correlations were attained over the concentration range of 1–35 μg/mL and 2–35 μg/mL for amlodipine besylate and irbesartan, respectively. The methods were validated according to the International Conference on Harmonization guidelines with good results.
Conclusion
The methods developed were successfully applied for the assay of the cited drugs in their marketed formulation. They could be efficiently used for routine analysis of the mentioned drugs in QC laboratories.
Highlights
The proposed approaches do not require expensive solvents or complex instruments. They could be used in routine laboratory tests where time and cost are crucial.
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Affiliation(s)
- Dina A El Mously
- Cairo University, Faculty of Pharmacy, Analytical Chemistry Department , Kasr-El-Aini St , 11562 Cairo, Egypt
| | - Nadia M Mostafa
- Cairo University, Faculty of Pharmacy, Analytical Chemistry Department , Kasr-El-Aini St , 11562 Cairo, Egypt
| | - Nagiba Y Hassan
- Cairo University, Faculty of Pharmacy, Analytical Chemistry Department , Kasr-El-Aini St , 11562 Cairo, Egypt
| | - Ghada M El-Sayed
- Cairo University, Faculty of Pharmacy, Analytical Chemistry Department , Kasr-El-Aini St , 11562 Cairo, Egypt
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Chang H, Gu HX, Gong M, Han JJ, Wang Y, Xia ZL, Zhao XM. Characteristic enhancement of blood pressure V-shaped waves in sinoaortic-denervated rats in a conscious and quiet state. Physiol Res 2016; 65:571-580. [PMID: 26988153 DOI: 10.33549/physiolres.933062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A hemodynamic feature of chronic sinoaortic-denervated (SAD) rats is the increase in blood pressure variability (BPV) without significant changes in the average level of blood pressure (BP). The current study was designed to investigate the changes in BP V-shaped waves (V waves) in SAD rats. Sprague-Dawley (SD) rats were divided into 2 groups: SAD rats and sham-operated rats (n=13). Hemodynamics measurements were obtained in conscious, freely moving rats, four weeks after sinoaortic denervation or sham operation. V wave indices were evaluated in rats in both conscious and quiet states. Additionally, normal and high BPV was simulated by the production of V waves with different amplitudes. The results showed that the V wave amplitude was dramatically increased, with a significantly prolonged duration and reduced frequency in SAD rats. V wave BPV in SAD rats was significantly increased, though BP remained unchanged. The twenty-four hour BPV in all rats was positively correlated with amplitude, duration time and V wave BPV and negatively correlated with frequency. The systolic BP spectral powers in the low frequency range (0.38-0.45 Hz) were significantly reduced in the V waves of SAD rats. Moreover, there was a remarkable increase in mean BPV and a normal mean BP after simulating high BPV in SAD rats. These results suggest that enhancement of V waves might be a waveform character of BP in SAD rats in both the conscious and quiet states. These types of V waves appear to be related to a depression of sympathetic regulation of BP induced by sinoaortic denervation.
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Affiliation(s)
- Huan Chang
- Key Laboratory of Atherosclerosis in Universities of Shandong (Taishan Medical University), Taian, China.
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Michel MC, Brunner HR, Foster C, Huo Y. Angiotensin II type 1 receptor antagonists in animal models of vascular, cardiac, metabolic and renal disease. Pharmacol Ther 2016; 164:1-81. [PMID: 27130806 DOI: 10.1016/j.pharmthera.2016.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/30/2016] [Indexed: 02/07/2023]
Abstract
We have reviewed the effects of angiotensin II type 1 receptor antagonists (ARBs) in various animal models of hypertension, atherosclerosis, cardiac function, hypertrophy and fibrosis, glucose and lipid metabolism, and renal function and morphology. Those of azilsartan and telmisartan have been included comprehensively whereas those of other ARBs have been included systematically but without intention of completeness. ARBs as a class lower blood pressure in established hypertension and prevent hypertension development in all applicable animal models except those with a markedly suppressed renin-angiotensin system; blood pressure lowering even persists for a considerable time after discontinuation of treatment. This translates into a reduced mortality, particularly in models exhibiting marked hypertension. The retrieved data on vascular, cardiac and renal function and morphology as well as on glucose and lipid metabolism are discussed to address three main questions: 1. Can ARB effects on blood vessels, heart, kidney and metabolic function be explained by blood pressure lowering alone or are they additionally directly related to blockade of the renin-angiotensin system? 2. Are they shared by other inhibitors of the renin-angiotensin system, e.g. angiotensin converting enzyme inhibitors? 3. Are some effects specific for one or more compounds within the ARB class? Taken together these data profile ARBs as a drug class with unique properties that have beneficial effects far beyond those on blood pressure reduction and, in some cases distinct from those of angiotensin converting enzyme inhibitors. The clinical relevance of angiotensin receptor-independent effects of some ARBs remains to be determined.
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Affiliation(s)
- Martin C Michel
- Dept. Pharmacology, Johannes Gutenberg University, Mainz, Germany; Dept. Translational Medicine & Clinical Pharmacology, Boehringer Ingelheim, Ingelheim, Germany.
| | | | - Carolyn Foster
- Retiree from Dept. of Research Networking, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Yong Huo
- Dept. Cardiology & Heart Center, Peking University First Hospital, Beijing, PR China
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Pliquett RU, Benkhoff S, Jung O, Brandes RP. Sympathoactivation and rho-kinase-dependent baroreflex function in experimental renovascular hypertension with reduced kidney mass. BMC PHYSIOLOGY 2014; 14:4. [PMID: 24946879 PMCID: PMC4074138 DOI: 10.1186/1472-6793-14-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/13/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Dysregulation of the autonomic nervous system is frequent in subjects with cardiovascular disease. The contribution of different forms of renovascular hypertension and the mechanisms contributing to autonomic dysfunction in hypertension are incompletely understood. Here, murine models of renovascular hypertension with preserved (2-kidneys-1 clip, 2K1C) and reduced (1-kidney-1 clip, 1K1C) kidney mass were studied with regard to autonomic nervous system regulation (sympathetic tone: power-spectral analysis of systolic blood pressure; parasympathetic tone: power-spectral analysis of heart rate) and baroreflex sensitivity of heart rate by spontaneous, concomitant changes of systolic blood pressure and pulse interval. Involvement of the renin-angiotensin system and the rho-kinase pathway were determined by application of inhibitors. RESULTS C57BL6N mice (6 to 11) with reduced kidney mass (1K1C) or with preserved kidney mass (2K1C) developed a similar degree of hypertension. In comparison to control mice, both models presented with a significantly increased sympathetic tone and lower baroreflex sensitivity of heart rate. However, only 2K1C animals had a lower parasympathetic tone, whereas urinary norepinephrine excretion was reduced in the 1K1C model. Rho kinase inhibition given to a subset of 1K1C and 2K1C animals improved baroreflex sensitivity of heart rate selectively in the 1K1C model. Rho kinase inhibition had no additional effects on autonomic nervous system in either model of renovascular hypertension and did not change the blood pressure. Blockade of AT1 receptors (in 2K1C animals) normalized the sympathetic tone, decreased resting heart rate, improved baroreflex sensitivity of heart rate and parasympathetic tone. CONCLUSIONS Regardless of residual renal mass, blood pressure and sympathetic tone are increased, whereas baroreflex sensitivity is depressed in murine models of renovascular hypertension. Reduced norepinephrine excretion and/or degradation might contribute to sympathoactivation in renovascular hypertension with reduced renal mass (1K1C). Overall, the study helps to direct research to optimize medical therapy of hypertension.
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Affiliation(s)
- Rainer U Pliquett
- Institute for Cardiovascular Physiology, Vascular Research Centre, Fachbereich Medizin, Goethe University, Frankfurt (Main), Germany.
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Perez-Lloret S, Rey MV, Pavy-Le Traon A, Rascol O. Orthostatic hypotension in Parkinson’s disease. Neurodegener Dis Manag 2013. [DOI: 10.2217/nmt.13.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
SUMMARY Orthostatic hypotension (OH) is a frequent non-motor symptom in Parkinson’s disease (PD), affecting between 22.9 and 38.4% of patients. In PD, OH is related to an increased risk of falls, and possibly to cognitive dysfunction and increased mortality. These data emphasize the importance of its prompt recognition and treatment. OH is related to pre- and post-ganglionic adrenergic denervation, but other factors, such as drugs, heat, meals or alcohol intake, might also induce or aggravate it. Evidence about the efficacy and safety of pharmacological or nonpharmacological strategies for OH treatment in PD is weak. Nonpharmacological measures include liberal addition of salt to the diet, exercise, compression stockings or physical maneuvers. Severe cases may be treated with midodrine or fludrocortisone. Some results suggest that droxidopa and fipamezole may be effective treatments. We finish this review article by discussing the most important unanswered questions about PD-related OH, which may be the focus of future research.
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Affiliation(s)
- Santiago Perez-Lloret
- Clinical Pharmacology & Epidemiology Laboratory, Pontifical Catholic University, Buenos Aires, Argentina
- Departments of Clinical Pharmacology & Neurosciences, & Clinical Investigation Center CIC9302, Institut National de la Santé & de la Recherche Médicale & University Hospital, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France
| | - María Verónica Rey
- Departments of Clinical Pharmacology & Neurosciences, & Clinical Investigation Center CIC9302, Institut National de la Santé & de la Recherche Médicale & University Hospital, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France
- Clinical Pharmacology & Epidemiology Laboratory, Pontifical Catholic University, Buenos Aires, Argentina
| | - Anne Pavy-Le Traon
- Departments of Clinical Pharmacology & Neurosciences, & Clinical Investigation Center CIC9302, Institut National de la Santé & de la Recherche Médicale & University Hospital, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France
| | - Olivier Rascol
- Departments of Clinical Pharmacology & Neurosciences, & Clinical Investigation Center CIC9302, Institut National de la Santé & de la Recherche Médicale & University Hospital, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France
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Höcht C. Blood Pressure Variability: Prognostic Value and Therapeutic Implications. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/398485] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Blood pressure variability (BPV) is considered nowadays a novel risk factor for cardiovascular disease. Early findings in sinoaortic denervated rats have clearly shown that enhanced fluctuation of blood pressure induced left ventricular hypertrophy, vascular stiffness, and renal lesion. A large number of clinical trials confirm that short-term and long-term blood pressure variability independently contributes to target organ damage, cardiovascular events, and mortality not only in hypertensive patients but also in subjects with diabetes mellitus and chronic kidney disease. Therefore, amelioration of BPV has been suggested as an additional target of the treatment of cardiovascular diseases. Preliminary evidence obtained from meta-analysis and controlled clinical trials has shown that antihypertensive classes differ in their ability to control excessive BP fluctuations with an impact in the prevention of cardiovascular events. Calcium channel blockers seem to be more effective than other blood pressure lowering drugs for the reduction of short-term and long-term BPV. In order to increase actual knowledge regarding the prognostic value and therapeutic significance of BPV in cardiovascular disease, there is a need for additional clinical studies specifically designed for the study of the relevance of short-term and long-term BPV control by antihypertensive drugs.
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Affiliation(s)
- Christian Höcht
- Cátedra de Farmacología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, 1113 Buenos Aires, Argentina
- Instituto de Fisiopatología y Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, 1113 Buenos Aires, Argentina
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Perez-Lloret S, Rey MV, Pavy-Le Traon A, Rascol O. Emerging drugs for autonomic dysfunction in Parkinson's disease. Expert Opin Emerg Drugs 2013; 18:39-53. [DOI: 10.1517/14728214.2013.766168] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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