Effect of angiotensin converting enzyme inhibitor on chronic ischemic patients.
Most of patients with cerebrovascular disease are associated with hypertension. Hypertension induces progressive atheromatous changes in cerebral arteries, and often causes steno-occlusive lesions of cerebral arteries. Angiotensin converting enzyme (ACE) inhibitor cilazapril is one of the antihypertensive drugs. It was reported that cilazapril improved resting cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) in experimental studies. In this clinical study, the authors investigated whether long-term treatment with cilazapril could improve CBF and CRC in patients with steno-occlusive lesions of the major cerebral arterial trunk, measured by stable xenon computerized tomography (Xe-CT) with acetazolamide challenge. On the other hand, CBF and CRC in the calcium blocker-treated patients were measured in the same way. CBF did not change after long-term treatment with both cilazapril and calcium blocker. In the cilazapril-treated group, CRC was increased significantly (p < 0.05). However, CRC did not change in the calcium blocker-treated group. It was recognized that long-term treatment with cilazapril did not decrease CBF and improved CRC in patients with occlusive lesions of the major cerebral arterial trunk.
Kawakami
N
N
Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.
Yamashita
T
T
Nakano
S
S
Ishihara
H
H
Kitahara
T
T
Nakashima
K
K
Kashiwagi
S
S
Ito
H
H
D000086:Acetazolamide; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use; D016893:Carotid Stenosis / Q000188:drug therapy / Q000503:physiopathology; D017315:Cilazapril / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D014057:Tomography, X-Ray Computed; D014978:Xenon
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D017315:Cilazapril; D014978:Xenon; D000086:Acetazolamide