Attenuation by ACE inhibitor drugs of alpha-adrenoceptor sensitivity in human vessels: possible differences related to drug lipophilicity

Acute effects of renin-angiotensin system blockade on arterial function in hypertensive patients

The acute effects of the renin-angiotensin system (RAS) blockers may be important in some clinical settings. To assess the acute impact of such drugs on arterial function, we studied the effects of captopril 25 mg, quinapril 20 mg and telmisartan 80 mg on 100 hypertensive patients, according to a randomized, double-blind, placebo-controlled study. Central (aortic) blood pressure (BP) and augmentation index (AIx, a measure of wave reflections), as well as flow-mediated dilatation (FMD) of the brachial artery and forearm blood flow (FBF) (measures of conduit and resistance artery endothelial function, respectively), were evaluated before and 2 h after oral drug administration. Compared to placebo, captopril and quinapril decreased central systolic (by 7.5 mm Hg, P<0.05 and by 12.3 mm Hg, P<0.001) and diastolic BP (by 4.9 mm Hg, P<0.01 and by 8.4 mm Hg, P<0.001), whereas telmisartan had no significant effect (P=NS). Additionally, AIx was reduced after quinapril (absolute decrease of 7.2%, P<0.01) and marginally after captopril (decrease of 4.7%, P=0.07). Only quinapril led to a beneficial change of FMD (absolute increase of 2.7%, P<0.001). No treatment was related to significant changes of peak hyperaemic or 3-min hyperaemic FBF. In adjusted analyses, all the favourable alterations induced by quinapril were independent of potential confounding haemodynamic factors. Our data show that acute RAS inhibition with quinapril (20 mg) may be more beneficial in terms of arterial function and central haemodynamics compared to captopril (25 mg) or telmisartan (80 mg). Further studies are needed to investigate whether these acute arterial effects of quinapril are clinically significant.

Rapid determination of partition coefficients between n-octanol/water for cardiovascular therapies

The lipid solubility of a pharmaceutical may greatly influence its tissue activity. To evaluate lipid solubility of a group of cardiovascular agents a procedure to determine partition coefficients in n-octanol/water for a series of cardiovascular compounds was described. Ultraviolet absorbance measurements were used to assess partitioning between the two liquid phases of these compounds. In this study, sotalol was found to be the most hydrophilic (n-octanol/water ratio of 0.33) and fosinopril-sodium was the most lipophilic (ratio of 6.19). This is a versatile method permitting the evaluation of lipophilicity and, thus, parameters governing the events leading to pharmacologic actions such as gastrointestinal dissolution, absorption, and bioavailability. These observations can be related to a drug series, composed of several compounds having structural similarities or minor variations. The lipid solubility of a compound can markedly alter its side-effects profile, especially because lipophilic drugs enter the central nervous system with facility. Additionally, lipophilic agents may enter target tissue with greater ease than nonlipophilic compounds and thus possess local intracellular effects in addition to a macro systemic action.

Inhibitory effect of insulin on bradykinin-induced venodilation

BACKGROUND

Excessive insulin is one of the risk factors of hypertension and arteriosclerosis despite its vasodilative properties shown in recent studies. Although many vasoactive substances contribute and interact with each other in the development of hypertension, the interactions between insulin and other vasoactive substances have yet to be elucidated.

OBJECTIVE

To assess the effect of insulin on the action of bradykinin.

METHODS

The vasodilating effect of bradykinin was evaluated, with or without coadministration of insulin, in human dorsal hand veins of healthy volunteers. In cultured porcine aortic endothelial cells, the bradykinin-induced increase of intracellular calcium was also investigated before and after insulin administration.

RESULTS

Insulin significantly attenuated bradykinin-induced increase in intracellular calcium and venodilation in cultured endothelial cells and human dorsal hand veins, respectively.

CONCLUSIONS

These findings suggest that insulin attenuates the bradykinin-induced calcium elevation in endothelial cells and may decrease the production of vasodilative substances from endothelial cells, resulting in the reduction of vasodilation. This effect may contribute to the development of hypertension in patients with hyperinsulinaemia.