경증 및 중등도 고혈압 환자에서 Fosinopril 단독 투여에 의한 강압 효과

Abstract

Background: The angiotensin-converting enzyme inhibitors have been found to be safe and efficacious in the treatment of essential hypertension. Fosinopril is the first angiotensin-converting enzyme inhibitor from a new class of agents containing phosphorus. This drug is known to be metabolized to almost and equal extent by the hepatic and renal pathways.

Methods: This study was performed to investigate the efficacy and safety of oral fosinopril, a new class of phosporus-containing angiotensin converting enzyme inhibitor, on essential hypertension. A single daily dose of 10mg to 20mg fosinopril was administered in 21 hypertensive patients with diastolic blood pressure in the range of 95mmHg-115mmHg while off all other anti-hypertensive agents for 10 weeks. Blood pressure and heart rate were measured every 4 weeks. The complete blood count, blood chemistry by SMA-12, serum electrolytes and urinalysis were performed at 12th week of therapy.

Results: 1) Baseline systolic and diastolic blood pressures after 2 weeks of placebo at sitting position were 158.8±15.7 and 99.4±6.3mmHg respectively. There was a statistcally significant reduction of blood pressure after 4 week treatment of fosinopril which was maintained up to 12 weeks of follow-up(158.8±15.7-99.4±6.3mmHg vs 139.3±18.2/86.6±10.3mmHg, p<0.05).

2) The proportion of responders defined by diastolic blood pressures less than 90mmHg or decline more than 10mmHg at 4, 8 and 12 weeks after treatment with fosinopril were 90.5, 95.2, and 95.2% respectively.

3) THere were no significant changes in blood chemistry, serum electrolytes, hematologic findings and heart rate over the treatment period.

4) Three patients experienced severe non-productive cough that required to discontinue the medication.

Conclusion: In patients with mild to moderate hypertension, once-daily fosinopril(10mg and 20mg) provided significant anti-hypertensive effects without serious side effects. The 10mg dose was effective in majority of patients and may be considered as a starting dose.