Comparison of the oral angiotensin II receptor antagonist UP 269-6 or enalapril 20 mg on blood pressure and neurohormonal effects in salt-deplete man

J Cardiovasc Pharmacol. 1995 Jun;25(6):994-1000. doi: 10.1097/00005344-199506000-00020.

Abstract

We compared the response of the oral angiotensin II (Ang II) receptor antagonist (ARA) UP 269-6 with an angiotensin converting enzyme inhibitor (ACEI) enalapril 20 mg or placebo, during salt depletion in normal men. We also evaluated safety and tolerability. Sixteen healthy, normotensive male volunteers followed a standardised salt-depletion regimen for 3 days before each study day. Seven different doses of UP 269-6 (5, 10, 20, 40, 80, 120 and 180 mg) were administered double blind in a four-panel dose escalation, with enalapril and placebo randomised within each panel. Supine and erect blood pressure (BP) and heart rate (HR); serum and urinary electrolytes; plasma active renin (PAR), aldosterone, and Ang II were measured at intervals. Urinary electrolytes and aldosterone were measured for the 24 h before dosing and for 24 h after dosing. Dizziness and light-headedness on standing were reported after UP 269-6 at higher doses. Enalapril caused one episode of symptomatic postural hypotension. No other drug-related adverse events (AE) were noted. There was a dose-related decrease in supine and erect systolic and diastolic BP (SBP, DBP) with UP 269-6 at > or = 40 mg, with no change in HR. Based on the maximal decrease in mean arterial pressure (MAP), UP 269-6 at 180 mg had an effect largely comparable to that of enalapril 20 mg. There was a dose-related increase in PAR with UP 269-6. Although this was greater with UP 269-6 180 mg than with enalapril, serum and 24-h urinary aldosterone suppression was greater with enalapril than with any dose of UP 269-6.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Aldosterone / blood
  • Aldosterone / urine
  • Angiotensin II / blood
  • Angiotensin Receptor Antagonists*
  • Angiotensin-Converting Enzyme Inhibitors / administration & dosage
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / pharmacology*
  • Blood Pressure / drug effects*
  • Creatinine / blood
  • Creatinine / urine
  • Diet, Sodium-Restricted
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Electrolytes / blood
  • Electrolytes / urine
  • Enalapril / administration & dosage
  • Enalapril / adverse effects
  • Enalapril / pharmacology*
  • Heart Rate / drug effects
  • Humans
  • Male
  • Pyrimidines / administration & dosage
  • Pyrimidines / adverse effects
  • Pyrimidines / blood
  • Pyrimidines / pharmacology*
  • Radioimmunoassay
  • Renin / blood
  • Tetrazoles / administration & dosage
  • Tetrazoles / adverse effects
  • Tetrazoles / blood
  • Tetrazoles / pharmacology*

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Electrolytes
  • Pyrimidines
  • Tetrazoles
  • Angiotensin II
  • UP 269-6
  • Aldosterone
  • Enalapril
  • Creatinine
  • Renin