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Coverex Review Article

 

hypertensionCoverex is an ACE inhibitor. Angiotensin II is very potent chemical that causes the muscles surrounding the blood vessels to contract and so doing it narrows the blood vessels. Consequently, when blood vessels get narrowed, it increases your blood pressure and turns down to Hypertension. Angiotensin II is formed from angiotensin I in the blood by the enzyme, angiotensin converting enzyme (ACE). ACE inhibitors are medications that slow (inhibit) the activity of the enzyme, which decreases the production of angiotensin II. As a result, when blood vessels enlarge or dilate, the blood pressure is reduced. At this stage, it makes easier for the heart to pump blood normally and in contrast it prevents from heart failure diseases. Thus, the rampant and raging of kidney disease due to high blood pressure or diabetes is slowed and getting prevented.

Coverex (Perindopril erbumine) and hypertension

In recent time, World Health Organization (WHO) has confirmed that high blood pressure (Hypertension) and Diabetes appeared to be two of the most dangerous disease, especially to elders and individuals who have kidney problems. Global statistic records that 72 million - or one in three adults - have high blood pressure. Prevalence rates are steadily rising, from a rate of 25%, or 50 million adults, between 1988 and 1994 to 29%, or 65 million people by 2002 (U.S. Government data); Continue reading...

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by 2010, the number of people suffering from Hypertension would rise more than 60%, which also means an estimated 1.56 billion people worldwide could be affected by the condition by 2025. Representatively, in the U.S., the number of adults with high blood pressure will increase from 333 million to 413 million by 2025 (Healthcare Professional and Patient advocacy Organizations, Washington, D.C).


Hypertension by Age
Such controversial condition has led to numerous research about Hypertension and Diabetes cures. Among those, Coverex (Perindopril erbumine), which is grouped as ACE Inhibitors (Angiotensin Converting Enzyme), has been proved to work effectively for patients enduring high blood pressure and urinary problems since its mechanism acts directly on the Renin-Angiotensin-Aldosterone System.


The Renin-Angiotensin-Aldosterone System plays a key role in pathophysiology of Hypertension and Diabetes since it regulates the plasma’s osmotic pressure by controlling fluid, electrolyte and blood volume. This mechanism is originally executed by Angiotensinogen, an hormone produced in Liver and will convert into Angiotensin II, which is responsible for causing potent vasoconstriction, aldosterone secretion and sympathetic activation. All of these actions contribute to the development of Hypertension.


The Renin-Angiotensin-Aldosterone System and ACE Inhibitors
Some specific effects and their subsequences of Angiotensin II have already been figured out can be seen as:

- Stimulate the volume of Sympathetic activity. This leads to increasing heartbeat, increasing circulating volume and increasing blood pressure.

- Moderate the actions in Urinary system (reabsorption of Na+ and Cl-, K+ excretion in distal tubule and H2O retention).These actions, altogether, result in increasing the blood pressure due to the changes in plasma osmotic pressure. This result also is the same for the effect of stimulating the Adrenal Cortex to produce Aldosterone hormone of Angiotensin II.

One dangerous effect of Angiotensin II is that it thickens the smooth muscle surrounding blood vessels (Arteriolar vasoconstriction), leading to blood vessels (arteriolar) narrowness and then blood pressure is increased. Meanwhile, due to the vessels narrowness, the blood volume providing for the whole body is not maintained in a proper quantity, which makes the heart work harder in order to strengthen the blood stream and guarantee normal body’s functions. This can cause Hypertrophic Cardiopathy (over-sized heart causing by over working) and sudden heart failure.


Coverex
It is the responsibility of ACE Inhibitor as Coverex (Perindopril erbumine. Other trade name Coversyl) to interrupt this process of producing Angiotensin II in order to minimize consequences of high blood pressure. With proper reduction of Angiotensin II, the volume of sympathetic system, circulatory system and urinary system is conditioned, the blood pressure is lowered and certain cardiac disease can be eliminated. In addition, due to those affections to adrenal system, Coverex also works for diabetes by reducing the renal imparement of patients who are under kidney disease. According to AIPRI (ACE in the Progression of Renal Impairment), the most recent and substantial study about the primary role of ACE-inhibitors in reducing the pace of renal impairment progression, the effects of ACE Inhibitors on patients involed in kidney disease are considerably high and worth-taking.


ACE Inhibitors


Further effectiveness of ACE Inhibitors has also been recorded through certain good results from intensive research about ACE Inhibitors’ effect on Hypertension and other concerned disease. After the random survey of 1,003 diabetics (Dr. Benjamin Littenberg and the University of Vermont , 2008), some promising results of ACE Inhibitors have been reported: ACE inhibitor users were less likely than non-users to report a history of cancer. In addition, ACE inhibitor users were also less likely than non-users to have a history of stomach ulcers or peptic ulcer disease (12% vs 16%). Particularly, Dr. Littenberg has come up with a conclusion that ACE Inhibitors appears to have potential slowing down the proliferation of various harmful cell types, as Breast cancer cell for represent, and reduce the tumor growth in experimental models of cancer.


COVEREX (Perindopril erbumine) INTERATIONS
ACE Inhibitor can be seen as Hypertension cure, used in relieving high blood pressure and other cardiac disease as well (most important is sudden heart failure). These functions are also the same for Beta Blockers medication drugs (commonly Acebutolol, Atenolol, Metoprotol, Nadolol). However, these two seeming-similar substances should not be used in a same time due to the risk that Beta blockers can ameliorate the negative effects of ACE Inhibitors. This may lead to the recurrence in Breast cancer survivors, basing on the data from Life After Cancer Epidemiology (LACE) (Steve Cole, Ph.D. , Patricia Ganz, M.D., Erica Sloan, Ph.D, 2011) study of 1799 patients which are in the early-stage of breast cancer.
Nevertheless, specific intensive information of using ACE Inhibitors and Beta Blockers will need more time to be put into real life.
Other substances that may highly have unpleasant interactions with ACE Inhibitors can be counted as ones which contain ADH hormone (Anti-Diuretic Hormone) (Vasopressin). ACE Inhibitors do its actions by decreasing the heartbeat and blood pressure, also including the condition of stimulating the diuresis. That means medication drugs belonging to the group of Anti-diuretic have totally reverse actions to ACE Inhibitors. Therefore, using medication drugs for various abnormal conditions of body should be carefully monitored by specialists.


Perindopril
*Aspirin: The interactions of ACE Inhibitors with Aspirin till now has been discussed and researched intensively. So far, it’s been confirmed that low-dose aspirin (less than or equal to 100 mg daily) leaves less effects when using with the ACE Inhibitors. However, high-dose aspirin taken in the same course of using ACE Inhibitors may restrain both benefits of aspirin and ACE Inhibitors, due to the difference in aspirin’s and ACE Inhibitors’ actions to the body. Specific mechanism still remains indeterminate and it is essential for patients who use these two medication in a same time to be carefully monitored though there has been widely common usage of aspirin in long term low-dose as a cure to control high blood pressure and coronary heart disease (World Health Organization-International Society of Hypertension guidelines for treatment of hypertension, 1999). Statistic about this controversial affair is various and many symptoms that reflect the abnormality of using high-dose aspirin with ACE Inhibitors change through research and studies (most commonly, patients who use parallel aspirin with ACE Inhibitors give lower results).


SIDE EFFECTS

ACE Inhibitors’ regular negative effects have been reported are cough, elevated blood potassium levels, low blood pressure, dizziness, headache, drowsiness, weakness, abnormal taste (metallic or salty taste), and rash. Among these undesirable consequences, kidney failure, allergic reactions, decrease in white blood cells, and swelling of tissues (angioedema) can be seen as the most serious cases but luckily, they rarely happen.

There are some important notes which patients who are about to use ACE Inhibitors should know:

- Drugs like ACE Inhibitors can be transported through placenta. Women in pregnancy are highly recommended not to use, due to the fact that ACE Inhibitors can leave abnormalities in gestation and harmfully affect to the baby.

- Elder patients are sensitive users whose many systems inner function in unpredictable ways (especially the urinary system, circulatory system and endocrine system) should take serious tests about the general body’s conditions and the functions of important systems before getting in the course of using ACE Inhibitors.


REFERENCES

DAPHNE P. BICKET, M.D., M.L.S., University of Pittsburgh Medical Center–McKeesport, McKeesport, Pennsylvania, Using ACE Inhibitors appropriately, 2002

World Health Organization - International Society of Hypertension guidelines for treatment of hypertension, 1999.

Golan L, Birkmeyer JD, Welch HG., The Cost-Effectiveness of Treating All Patients with Type 2 Diabetes with Angiotensin-Converting Enzyme Inhibitors, 1999

JULIENNE K. KIRK, PHARM.D., Wake Forest University School of Medicine, Winston-Salem, North Carolina, Angiotensin-II Receptor Antagonists: Their Place in Therapy, 1999

Journal of Cardiovascular Pharmacology: 1999 - Volume 33 - Issue - pp S16-S20, Novel Approaches In Treating Hypertension And Renal Disease Via Blockade Of The Renin-Angiotensin System

Steve C., Ph.D. , Patricia Ganz, M.D., Erica Sloan, Ph.D, UCLA’S Jonsson Comprehensive Cancer Center, ACE Inhibitors may Increase Risk of Recurrence in Breast Cancer Survivors, 2011


 

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