Summary
The effect of the angiotensin converting enzyme inhibitor, perindopril, on autonomic function was assessed in a double blind, placebo controlled, crossover study in 10 normotensive males. Eight milligram of perindopril given orally lowered blood pressure without a change in heart rate. Perindopril enhanced the vagally mediated heart rate variation with deep breathing. There was no impairment of the responses to either bicycle exercise at 175 W for 5 min or isometric handgrip. The pressor response to cold was not changed and the response to the Valsalva manoeuvre was unaltered. These results suggest that the absence of tachycardia after perindopril may be in part related, as has been reported with other converting enzyme inhibitors, to enhanced cardiac parasympathetic tone. Vagomimetic action may be a property of converting enzyme inhibitors in general.
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References
Laubie M, Schiavi P, Vincent P, Schmitt H (1984) Inhibition of angiotensin I converting enzyme with S-9490: Biochemical effects, interspecies differences, and role of sodium diet in haemodynamic effects. J Cardiovasc Pharmacol 6: 1076–1082
Lees KR, Reid JL (1985) Single and multiple administration of an angiotensin converting enzyme inhibitor, S-9490-3, in normotensive subjects. Br J Clin Pharmacol 19 [1]: 132–133p
Millar JA, Derkx FM, McLean Kathleen, Reid JL (1982) Pharmacodynamics of converting enzyme inhibition: The cardiovascular endocrine and autonomic effects of MK421 and MK521. Br J Clin Pharmacol 14: 347–355
Hatton R, Clough D, Faulkner K, Conway J (1981) Angiotensin converting enzyme inhibitor resets baroreceptor reflexes in conscious dogs. Hypertension 3: 676–681
Niarchos AP, Pickering TG, Morganti A, Laragh JH (1982) Plasma catecholamines and cardiovascular responses during converting enzyme inhibition in normotensive man. Clin Exp Hypertens A4 [4 and 5] 761–789
Lin M, McNay JL, Sheperd AMM, Keeton TK (1983) Effects of hydralazine and sodium nitroprusside on plasma catecholamine and heart rate. Clin Pharmacol Ther 34 [4]: 474–480
Vidt DG, Bravo EL, Fouad FM (1982) Captopril. N Engl J Med 306 [4]: 214–219
Tarazai RC, Dustan HP, Niarchos AP (1976) Vasodilating drugs: Contrasting haemodynamic effects. Clin Sci Mol Med 51 [Suppl 3]: 575S
Levenson JA, Simon A Ch, Safar ME (1985) Vasodilation of small and large arteries in hypertension. J Cardiovasc Pharmacol 7: S115-S120
Sturani A, Chiarini C, Degli Esposti E, Santoro A, Zuccala A, Zuchelli P (1982) Heart rate control in hypertensive patients treated by captopril. Br J Clin Pharmacol 14: 849–855
Campbell BC, Sturani A, Reid JL (1985) Evidence of parasympathetic activity of the angiotensin converting enzyme inhibitor, captopril, in normotensive man. Clin Sci 68: 49–56
Ajayi AA, Campbell BC, Howie CA, Reid JL (1985) Acute and chronic effects of converting enzyme inhibitors on reflex control of heart rate in normotensive man. J Hypertension 3: 47–53
Bellavere F, Ewing DJ (1982) Autonomic control of the immediate heart rate response to lying down. Clin Sci 62: 57–64
Sharpey-Schafer EP (1955) Effects of Valsalva manoeuvre on normal and failing circulation. Br Med J 1: 693–695
Finley JP, Bonet JF, Waxman MB (1979) Autonomic pathways responsible for bradycardia on facial immersion. J Appl Physiol 47: 1218–1222
Wheeler T, Watkins TJ (1973) Cardiac denervation in diabetes. Br Med J 4: 584–586
Hines EA, Brown GE (1936) The cold pressor test for measuring the reactability of blood pressure: Data concerning 571 normal and hypertensive patients. Am Heart J 11: 1–9
Zimmerman BG (1981) Adrenergic facilitation by angiotensin; does it serve a physiological function? Clin Sci 60: 343
Starke K (1977) Regulation of noradrenaline release by the presynaptic receptor systems. Rev Physiol Biochem Pharmacol 3 [suppl 1]: 514–523
Ajayi AA, Campbell BC, Meredith PA, Kelman AW, Reid JL (1985) The effect of captopril on the reflex control of heart rate: possible mechanisms. Br J Clin Pharmacol 20: 17–25
Scroop GC, Lowe RD (1968) Central pressor effect of angiotensin mediated by the parasympathetic nervous system. Nature 220: 1331–1332
Lumbers ER, McCloskey DI, Potter EK (1979) Inhibition by angiotensin II of baroreceptor evoked activity in cardiac vagal efferent nerves in the dog. J Physiol 294: 69–80
Lee WB, Ismay MJ, Lumbers ER (1980) Mechanisms by which angiotensin II affects the heart rate of conscious sheep. Circ Res 47: 286–292
Potter EK (1982) Angiotensin inhibits action of the vagus nerve at the heart. Br J Pharmacol 75: 9–11
Loffelholz K, Muscholl E (1970) Inhibition by parasympathetic nerve stimulation of the release of the adrenergic transmitter. Naunyn-Schmiedelberg's Arch Pharmacol 267: 181–184
Joy MD, Lowe RD (1970) The site of cardiovascular action of angiotensin II in the brain. Clin Sci 39: 327–336
Wislocki GB, Putnam JJ (1924) Further observations on the activity and physiology of the area postrema Anat Rec 27: 151–156
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Ajayi, A.A., Lees, K.R. & Reid, J.L. Effects of angiotensin converting enzyme inhibitor, perindopril, on autonomic reflexes. Eur J Clin Pharmacol 30, 177–182 (1986). https://doi.org/10.1007/BF00614298
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DOI: https://doi.org/10.1007/BF00614298