Efficacy and safety of spirapril in mild-to-moderate hypertension.

Spirapril is a new angiotensin-converting enzyme (ACE) inhibitor. It is a prodrug with a resorption of about 50%. The active metabolite spiraprilat reaches maximal plasma concentration within 2-3 h after oral administration.

Is initial dose titration of amlodipine worthwhile in patients with mild to moderate hypertension?

Amlodipine, a dihydropyrimidine calcium antagonist, is effective in the treatment of patients with mild to moderate hypertension at doses of 5-10 mg daily. The aim of the study reported here was to determine whether an early increase in dosage of amlodipine provided an advantage in terms of antihypertensive effect. This was a single-blind, randomised study in 115 patients with mild to moderate hypertension (diastolic blood pressure 95-114 mmHg) conducted at 10 centres with two parallel groups.

Single daily administration of spirapril in the treatment of essential hypertension. A multicentre double-blind comparison of 1, 6, 12 and 24 mg of spirapril once daily.

A total of 171 male and female patients with mild-to-moderate hypertension [diastolic blood pressure (DBP) 100-115 mmHg] entered this randomized, double-blind, multicentre study. A 3-week placebo run-in period was followed by a 5-week active-treatment period during which patients received either 1, 6, 12 or 24 mg of spirpril once daily. Predose sitting blood pressure was taken in the morning by sphygmomanometer as well as by an automatic device (Tonoprint).

[Duodenal duplication cyst--a rare cause of acute recurrent pancreatitis].

We report on a 42-year-old male patient who has been treated over a period of five years because of acute relapsing pancreatitis. The diagnoses of viral pancreatitis, pancreatic pseudocyst, and choledochal cyst type III (choledochocele) have been erroneously made. The clinical and laboratory findings over this period are presented, compared with one another, and analyzed.

How well are the cardiovascular risk profiles modulated by current beta blockers in hypertension?

Epidemiologic studies predict that reduction of the systemic blood pressure by the amount usually achieved in major clinical trials could be expected to reduce cerebrovascular events by 42% and cardiac events by 24%. Although antihypertensive treatment achieves the expected cerebrovascular benefits, the risk of coronary events is reduced by only 14%. The reason for this dichotomy in cardiovascular protection afforded by antihypertensive drugs is unknown.