Drugs online research references
klinik.uni-regensburg.de
This study aimed to assess the impact of cyclooxygenase-2 (COX-2) on the secretion and expression of renin in the kidney cortex. For this purpose renocortical COX-2 expression was moderately stimulated by a low-salt diet or strongly stimulated (increase in mRNA about fivefold) by the combination of a low-salt diet and the angiotensin-I-converting enzyme inhibitor ramipril in male Sprague-Dawley rats. None of these manoeuvres changed medullary COX-2 expression or cortical or medullary COX-1 expression. Treatment with low salt plus ramipril but not with low salt alone led to a three- to fourfold increase of the urinary output of all major prostanoids. The selective COX-2 inhibitor rofecoxib (10 mg/kg per day) markedly lowered basal urinary prostanoid excretion and blunted the stimulation of prostanoid excretion during treatment with low salt plus ramipril. The stimulation of renin secretion by the low-salt diet but not by low salt plus ramipril was attenuated by rofecoxib. The low-salt diet led to a moderate increase of renin gene expression, and additional treatment with ramipril caused a 15-fold increase of renin mRNA. However, no effect of rofecoxib on renin gene expression was observed in any group. These findings suggest that stimulation of COX-2 in the renal cortex leads to the increased formation of all major prostanoids. COX-2-derived prostanoids may play a role in the regulation of renin secretion but not in renin gene expression during the intake of a low-salt diet. However, no major relevance of COX-2-derived prostanoids to renin secretion or renin gene expression during ramipril treatment or a combination of ramipril and a low-salt diet was found.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11680616&dopt=Abstract
Z Kardiol. 1994;83 Suppl 4:63-4.
[Reduction of infarct size and remodeling after ramipril]
[Article in German]
Martorana PA, Linz W, Scholkens BA.
Cassella AG, SGE Herz-Kreislauf Therapeutika, Frankfurt/Main.
It is known that angiotensin converting enzyme (ACE) inhibitors not only prevent the formation of angiotensin II, but also potentiate the activity of bradykinin. We investigated the effects of the ACE-inhibitor ramipril in two models of cardiac ischemia. In anesthetized dogs with a coronary occlusion of 6-h duration, both ramiprilat and bradykinin significantly reduced infarct-size. This effect was prevented by the co-administration of the bradykinin antagonist HOE 140. In rats with a coronary occlusion of 6-weeks duration, ramipril administration significantly reduced infarct-size and prevented the development of left ventricular hypertrophy. Thus, ramipril showed a cardioprotective activity in models of acute as well as of chronic myocardial ischemia. These effects are probably mediated by the potentiation of bradykinin.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7856282&dopt=Abstract
Int J Clin Pract Suppl. 2001 Jan;(117):19-21.
Pharmacoeconomic impact of HOPE.
Ostergren JB, Bjorholt I, Andersson F, Kahan T.
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
The HOPE (Heart Outcomes and Prevention Evaluation) study has demonstrated a clear and beneficial effect of ramipril on cardiovascular events and disease progression. The cost-effectiveness of treatment with ramipril remains an important question that is being addressed by analysis of data from the main HOPE study and from a Swedish substudy. Data from the main HOPE study indicate that hospital costs per patient were reduced in the ramipril group compared with the placebo group. The net effect indicates that ramipril is cost neutral or could even be cost saving in US non-Medicare patients. In the Swedish health economic substudy, a separate protocol and separate case record forms were utilised to generate more specific data from the 537 Swedish patients taking part in HOPE. In this analysis, costs and effects associated with each treatment group were assessed and incremental cost-effectiveness ratios were calculated. The primary analysis was cost per life year gained which amounted to 29,000 Swedish Kroner. In a world with a growing prevalence of cardiovascular disease and with additional constraints on healthcare expenditure, analysis of the cost-effectiveness of preventive and curative medications is increasingly important. In this context, the early observations on the cost-effectiveness of ramipril appear very hopeful.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11715354&dopt=Abstract
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