Navegando por Palavras-chave "Inibidores da enzima conversora da angiotensina"

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    Ação da inibição da enzima conversora da angiotensina em aorta, fígado, rim e pâncreas em condições de hipercolesterolemia e hiperglicemia induzidas experimentalmente
    (Universidade Federal de São Paulo (UNIFESP), 2010-07-28) Pomaro, Daniel Roberto [UNIFESP]; Ihara, Silvia Saiuli Miki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Diabetes Mellitus is a major risk factor for vascular disease and the imbalance of the renin-angiotensin system exerts deleterious effects on various organs, further the use of ACE inhibitor or AT1 receptor blockers may exerts a beneficial effect. Objective: We performed a retrospective study where the effect of an ACE inhibitor, quinapril, on changes in target organs such as aorta, liver, kidney and pancreas of diabetic and hypercholesterolemic rabbits was analyzed. Methods: We performed a retrospective study on tissue samples of aorta, liver, kidney and pancreas of alloxan-induced diabetic rabbits which have also become hypercolesterolemic through a rich cholesterol fed. The animals were divided into four groups according to glucose levels (Group I = 432 ± 45 mg / dL, Group II = 514 ± 40 mg / dL, Group III = 149 ± 09 mg / dL, Group IV = 156 ± 10 mg / dL). The rabbits in groups II and IV received quinapril (30 mg/day) in their food and all animals received a diet enriched with 0.5% cholesterol for 12 weeks. The following parameters were analyzed: in the aorta – the immunohistochemical expression of MCP-1 and ICAM-1, and an in vitro assay using endothelial cells of rabbit aorta by analyzing the expression thereof were analyzed. In the kidney – it was analyzed the histopathology, histomorphometry and the immunostaining of macrophages, MCP-1 and ICAM- 1. In the liver – we performed a histopathological analysis and the evaluation of fibrosis was accessed by image analysis. In the pancreas – it was analyzed the histopathologic and the histomorphometric changes and an in vitro assay using isolated islets from rabbits was performed to evaluate the oxidative stress. Results: In the aorta there was a reduction in the immunohistochemical expression of ICAM-1 by treatment with ACE inhibitors in both tissue and endothelial cells cultured, however, this reduction was abolished in the presence of high concentrations of glucose. The immunohistochemical expression of MCP-1 was lower in animals treated with ACE inhibitors, but in cell culture the immuno-expression was not modified by treatment with ACE inhibitors, but by the concentration of glucose in the medium. In the kidney, the use of an ACE inhibitor attenuated the glomerular lesions and reduced the immunohistochemical expression of ICAM-1 and MCP-1. In the liver, the use of an ACEI reduced hepatic fibrosis, but this protective effect was not significant in animals hyperglycemic. In the pancreas, the ACEI treatment did not protect the islets destroyed by alloxan, but in the in vitro assay the oxidative stress was reduced. Conclusion: We found that the ACE inhibitor attenuated the changes in the kidney, but in aorta, liver and isolated pancreatic islets this protection depends on glycemic control.
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    Oral drugs for hypertensive urgencies: systematic review and meta-analysis
    (Associação Paulista de Medicina - APM, 2009-11-01) Souza, Luciana Mendes de [UNIFESP]; Riera, Rachel [UNIFESP]; Saconato, Humberto; Demathé, Adriana; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Brazilian Cochrane Center; Universidade Federal do Rio Grande do Norte Department of Medicine; Universidade Estadual de São Paulo Department of Pathology and Propaedeutics
    CONTEXT AND OBJECTIVE: Hypertensive urgencies are defined as severe elevations in blood pressure without evidence of acute or progressive target-organ damage. The need for treatment is considered urgent but allows for slow control using oral or sublingual drugs. If the increase in blood pressure is not associated with risk to life or acute target-organ damage, blood pressure control must be implemented slowly over 24 hours. For hypertensive urgencies, it is not known which class of antihypertensive drug provides the best results and there is controversy regarding when to use antihypertensive drugs and which ones to use in these situations. The aim of this review was to assess the effectiveness and safety of oral drugs for hypertensive urgencies. METHODS: This systematic review of the literature was developed at the Brazilian Cochrane Center, and in the Discipline of Emergency Medicine and Evidence-Based Medicine at the Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina (UNIFESP-EPM), in accordance with the methodology of the Cochrane Collaboration. RESULTS: Sixteen randomized clinical trials including 769 participants were selected. They showed that angiotensin-converting enzyme inhibitors had a superior effect in treating hypertensive urgencies, evaluated among 223 participants. The commonest adverse event for calcium channel blockers were headache (35/206), flushing (17/172) and palpitations (14/189). For angiotensin-converting enzyme inhibitors, the principal side effect was bad taste (25/38). CONCLUSIONS: There is important evidence in favor of the use of angiotensin-converting enzyme inhibitors for treating hypertensive urgencies, compared with calcium channel blockers, considering the better effectiveness and the lower frequency of adverse effects (like headache and flushing).