The neurohumoral responses after 10 mg of felodipine extended release (ER), a new dihydropyridine calcium antagonist, and 25 mg of hydrochlorothiazide (HCTZ) were compared in a randomized, double-blind, crossover trial in 28 mild to moderate hypertensives. Antihypertensive drugs were gradually discontinued. Felodipine ER, 10 mg was given once daily for 2 weeks; after another washout period of 1 week, patients were switched to 25 mg of HCTZ once daily and vice versa. Blood pressure (BP) was measured at baseline, 2.5 h after medication, and after 2 weeks of treatment (24 h postdosing) using an oscillometric device. Felodipine ER and HCTZ both lowered BP effectively. However, felodipine ER was superior in reducing systolic and diastolic BP during the short term and medium term. Treatment with felodipine ER over 2 weeks increased sympathetic outflow as indicated by elevated plasma norepinephrine levels, whereas plasma epinephrine was mainly unaffected, as were plasma renin and aldosterone levels. On the other hand, 25 mg of HCTZ increased plasma renin and aldosterone, but left catecholamines unchanged. Despite persistent increased sympathetic activity, the reduction in BP in this study was more pronounced after felodipine ER as compared to HCTZ. The lack of a difference between heart rates under both medications after 2 weeks of treatment suggests a resetting of the baroreflex by felodipine ER and furthermore that the increased norepinephrine levels may not be clinically relevant, but demonstrate the maintained baroreflex activity. HCTZ, in doses as low as 25 mg, is still capable of stimulating the renin-angiotensin-aldosterone system.
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Curr Cardiol Rep
January 2025
Pediatric Advanced Heart Failure and Heart Transplant Program, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS, USA.
Purpose Of Review: Traditionally viewed as a passive player in circulation, the right ventricle (RV) has become a pivotal force in hemodynamics. RV failure (RVF) is a recognized complication of primary cardiac and pulmonary vascular disorders and is associated with a poor prognosis. Unlike treatments for left ventricular failure (LVF), strategies such as adrenoceptor signaling inhibition and renin-angiotensin system modulation have shown limited success in RVF.
View Article and Find Full Text PDFAm J Physiol Heart Circ Physiol
January 2025
Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, The Netherlands.
The acute response to therapeutic afterload reduction differs between heart failure with preserved (HFpEF) versus reduced ejection fraction (HFrEF), with larger left ventricular (LV) stroke work augmentation in HFrEF compared to HFpEF. This may (partially) explain the neutral effect of HFrEF-medication in HFpEF. It is unclear whether such differences in hemodynamic response persist and/or differentially trigger reverse remodeling in case of long-term afterload reduction.
View Article and Find Full Text PDFMov Disord Clin Pract
January 2025
Centro de Investigaciones en Psicología y Psicopedagogía (CIPP), Facultad de Psicología y Psicopedagogía, Pontificia Universidad Católica Argentina (UCA), Buenos Aires, Argentina.
Background: The cerebral Renin-Angiotensin System might have a role in anxiety and depression development.
Objective: We explored the effects of Angiotensin II Type 1 receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACE-Is) on anxiety and depression in Parkinson's Disease (PD).
Methods: Four hundred and twenty-three newly diagnosed drug-naïve PD patients were evaluated using the State-Trait Anxiety Inventory (STAI) and Geriatric Depression Scale (GDS-15) tests and were monitored at baseline and for up to 3 years.
Aten Primaria
January 2025
Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, España; Institut Català de la Salut, Barcelona, España.
Objective: To characterise patients with heart failure (HF) in Primary Health Care (PHC) and describe their socio-demographic and clinical characteristics and pharmacological treatment.
Design: Descriptive cohort study. SITE: Information System for the Development of Research in Primary Care (SIDIAP), which captures information from the electronic health records of PHC of the Catalan Institute of Health (approximately 80% of the Catalan population).
Chem Biodivers
January 2025
Hainan Pharmaceutical Research and Development Science Park, Hainan Academy of Medical Sciences, Hainan Medical University, Haikou, China.
One new monomeric citrinin analog (1) and 42 known compounds (2-43) were isolated from Penicillium citrinum W22. The structure of 1 was determined by detailed analysis of the 1D and 2D nuclear magnetic resonance (NMR), HRESIMS, and time-dependent density functional theory (TD-DFT)-based electronic circular dichroism (ECD) calculation. Penicitrinol A (2) and methyl 2-(2-acetyl-3,5-dihydroxy-4,6-dimethylphenyl) acetate (11) significantly inhibited renin-angiotensin system-selective lethal 3 (RSL3)-induced ferroptosis with half maximal effective concentration (EC) values of 1.
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