Moexipril (Monograph)
Drug class: Angiotensin-Converting Enzyme Inhibitors
- ACE Inhibitors
VA class: CV800
Chemical name: (3S-(2(R*(R*)),3R*))-2-(2-((1 -(Ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)-1,2,3,4-tetrahydro-6,7-dimethoxy-3-isoquinolinecarboxylic acid monohydrochloride
Molecular formula: C27H34N2O7•ClH
CAS number: 82586-52-5
Warning
Introduction
Nonsulfhydryl ACE inhibitor.1
Uses for Moexipril
Hypertension
Management of hypertension (alone or in combination with other classes of antihypertensive agents).1 2 5 25 83 1200
ACE inhibitors are recommended as one of several preferred drugs for the initial management of hypertension according to current evidence-based hypertension guidelines; other preferred options include angiotensin II receptor antagonists, calcium-channel blockers, and thiazide diuretics.501 502 503 504 1200 While there may be individual differences with respect to recommendations for initial drug selection and use in specific patient populations, current evidence indicates that these antihypertensive drug classes all generally produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.501 502 504 1200 1213
Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).501 502 503 504 515 1200 1201
A 2017 ACC/AHA multidisciplinary hypertension guideline classifies BP in adults into 4 categories: normal, elevated, stage 1 hypertension, and stage 2 hypertension.1200 (See Table 1.)
Source: Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13-115.
Individuals with SBP and DBP in 2 different categories (e.g., elevated SBP and normal DBP) should be designated as being in the higher BP category (i.e., elevated BP).
Category |
SBP (mm Hg) |
DBP (mm Hg) |
|
---|---|---|---|
Normal |
<120 |
and |
<80 |
Elevated |
120–129 |
and |
<80 |
Hypertension, Stage 1 |
130–139 |
or |
80–89 |
Hypertension, Stage 2 |
≥140 |
or |
≥90 |
The goal of hypertension management and prevention is to achieve and maintain optimal control of BP.1200 However, the BP thresholds used to define hypertension, the optimum BP threshold at which to initiate antihypertensive drug therapy, and the ideal target BP values remain controversial.501 503 504 505 506 507 508 515 523 526 530 1200 1201 1207 1209 1222 1223 1229
The 2017 ACC/AHA hypertension guideline generally recommends a target BP goal (i.e., BP to achieve with drug therapy and/or nonpharmacologic intervention) of <130/80 mm Hg in all adults regardless of comorbidities or level of atherosclerotic cardiovascular disease (ASCVD) risk.1200 In addition, an SBP goal of <130 mm Hg is recommended for noninstitutionalized ambulatory patients ≥65 years of age with an average SBP of ≥130 mm Hg.1200 These BP goals are based upon clinical studies demonstrating continuing reduction of cardiovascular risk at progressively lower levels of SBP.1200 1202 1210
Other hypertension guidelines generally have based target BP goals on age and comorbidities.501 504 536 Guidelines such as those issued by the JNC 8 expert panel generally have targeted a BP goal of <140/90 mm Hg regardless of cardiovascular risk and have used higher BP thresholds and target BPs in elderly patients501 504 536 compared with those recommended by the 2017 ACC/AHA hypertension guideline.1200
Some clinicians continue to support previous target BPs recommended by JNC 8 due to concerns about the lack of generalizability of data from some clinical trials (e.g., SPRINT study) used to support the 2017 ACC/AHA hypertension guideline and potentials harms (e.g., adverse drug effects, costs of therapy) versus benefits of BP lowering in patients at lower risk of cardiovascular disease.1222 1223 1224 1229
Consider potential benefits of hypertension management and drug cost, adverse effects, and risks associated with the use of multiple antihypertensive drugs when deciding a patient's BP treatment goal.1200 1220
For decisions regarding when to initiate drug therapy (BP threshold), the 2017 ACC/AHA hypertension guideline incorporates underlying cardiovascular risk factors.1200 1207 ASCVD risk assessment is recommended by ACC/AHA for all adults with hypertension.1200
ACC/AHA currently recommend initiation of antihypertensive drug therapy in addition to lifestyle/behavioral modifications at an SBP ≥140 mm Hg or DBP ≥90 mm Hg in adults who have no history of cardiovascular disease (i.e., primary prevention) and a low ASCVD risk (10-year risk <10%).1200
For secondary prevention in adults with known cardiovascular disease or for primary prevention in those at higher risk for ASCVD (10-year risk ≥10%), ACC/AHA recommend initiation of antihypertensive drug therapy at an average SBP ≥130 mm Hg or an average DBP ≥80 mm Hg.1200
Adults with hypertension and diabetes mellitus, chronic kidney disease (CKD), or age ≥65 years are assumed to be at high risk for cardiovascular disease; ACC/AHA state that such patients should have antihypertensive drug therapy initiated at a BP ≥130/80 mm Hg.1200 Individualize drug therapy in patients with hypertension and underlying cardiovascular or other risk factors.502 1200
In stage 1 hypertension, experts state that it is reasonable to initiate drug therapy using the stepped-care approach in which one drug is initiated and titrated and other drugs are added sequentially to achieve the target BP.1200 Initiation of antihypertensive therapy with 2 first-line agents from different pharmacologic classes recommended in adults with stage 2 hypertension and average BP >20/10 mm Hg above BP goal.1200
Black hypertensive patients generally tend to respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to ACE inhibitors.25 83 92 93 108 109 501 504 1200 However, the combination of an ACE inhibitor or an angiotensin II receptor antagonist with a calcium-channel blocker or thiazide diuretic produces similar BP lowering in black patients as in other racial groups.1200
ACE inhibitors may be preferred in hypertensive patients with heart failure, ischemic heart disease, diabetes mellitus, CKD, or cerebrovascular disease or post-MI.501 502 504 523 524 525 526 527 534 535 536 543 1200 1214 1215
Heart Failure
Management of heart failure† [off-label], usually in conjunction with other agents such as cardiac glycosides, diuretics, and β-adrenergic blocking agents (β-blockers).10 11 12 14 96 524 800
Some evidence indicates that therapy with an ACE inhibitor (enalapril) may be less effective than angiotensin receptor-neprilysin inhibitor (ARNI) therapy (e.g., sacubitril/valsartan) in reducing cardiovascular death and heart failure-related hospitalization.702 800
ACCF, AHA, and the Heart Failure Society of America (HFSA) recommend that patients with chronic symptomatic heart failure and reduced left ventricular ejection fraction (LVEF) (NYHA class II or III) who are able to tolerate an ACE inhibitor or angiotensin II receptor antagonist be switched to therapy containing an ARNI to further reduce morbidity and mortality.800
Diabetic Nephropathy
A recommended agent in the management of patients with diabetes mellitus and persistent albuminuria† [off-label] who have modestly elevated (30–300 mg/24 hours) or higher (>300 mg/24 hours) levels of urinary albumin excretion; slows rate of progression of renal disease in such patients.103 104 105 106 107 535 536 1232
Moexipril Dosage and Administration
General
BP Monitoring and Treatment Goals
-
Monitor BP regularly (i.e., monthly) during therapy and adjust dosage of the antihypertensive drug until BP controlled.1200
-
If unacceptable adverse effects occur, discontinue drug and initiate another antihypertensive agent from a different pharmacologic class.1216
-
If adequate BP response not achieved with a single antihypertensive agent, either increase dosage of single drug or add a second drug with demonstrated benefit and preferably a complementary mechanism of action (e.g., calcium-channel blocker, thiazide diuretic).1200 1216 Many patients will require ≥2 drugs from different pharmacologic classes to achieve BP goal; if goal BP still not achieved, add a third drug.1200 1216 1220
Administration
Oral Administration
Administer orally once or twice daily 1 hour before meals.1 3 83
Dosage
Available as moexipril hydrochloride; dosage expressed in terms of the salt.1 83
Adults
Hypertension
Moexipril Therapy
OralInitially, 7.5 mg once daily in patients not receiving a diuretic.1 5
In patients currently receiving diuretic therapy, discontinue diuretic, if possible, 2–3 days before initiating moexipril or cautiously increase salt intake.1 8 9 10 11 12 13 14 37 46 May resume diuretic therapy if BP not controlled adequately with moexipril alone.1 28 29 30 39 If diuretic cannot be discontinued, give lower initial moexipril dose (3.75 mg) under close medical supervision until BP has stabilized.8 10 11 12 13 14 83 84
Usual dosage: 7.5–30 mg daily, given in 1 dose or 2 divided doses.1 83 1200
If effectiveness diminishes toward end of dosing interval in patients treated once daily, consider increasing dosage or administering drug in 2 divided doses.1
Moexipril/Hydrochlorothiazide Fixed-combination Therapy
OralManufacturer states fixed-combination preparation should not be used for initial antihypertensive therapy.83
If BP is not adequately controlled by monotherapy with moexipril, can switch to the fixed-combination preparation containing moexipril hydrochloride 7.5 mg and hydrochlorothiazide 12.5 mg, moexipril hydrochloride 15 mg and hydrochlorothiazide 12.5 mg, or moexipril hydrochloride 15 mg and hydrochlorothiazide 25 mg.83 Adjust dosage of either or both drugs according to patient’s response.83
Prescribing Limits
Adults
Hypertension
Oral
Usually, maximum 30 mg daily.1 Dosages >60 mg daily have not been extensively evaluated in hypertensive patients.1 5
Special Populations
Renal Impairment
Hypertension
Oral
Initially, 3.75 mg once daily in patients with severe renal impairment (Clcr ≤40 mL/minute); titrate until BP is controlled or to maximum of 15 mg daily.1
Moexipril/hydrochlorothiazide fixed combination is not recommended in patients with severe renal impairment.83
Volume- and/or Salt-depleted Patients
Correct volume and/or salt depletion prior to initiation of therapy or initiate therapy under close medical supervision using lower initial dosage.1
Cautions for Moexipril
Contraindications
-
Known hypersensitivity to moexipril, any ingredient in the formulation, or any other ACE inhibitor.1 83
-
History of angioedema with prior ACE inhibitor treatment.1 83
-
Concomitant therapy with aliskiren in patients with diabetes mellitus.1 83
Warnings/Precautions
Warnings
Fetal/Neonatal Morbidity and Mortality
Possible fetal and neonatal morbidity and mortality when used during pregnancy.1 111 (See Boxed Warning.) Such potential risks occur throughout pregnancy, especially during the second and third trimesters.111
Also may increase the risk of major congenital malformations when administered during the first trimester of pregnancy.110 111
Discontinue ACE inhibitors (e.g., moexipril) as soon as possible when pregnancy is detected, unless continued use is considered lifesaving.1 110 111 Nearly all women can be transferred successfully to alternative therapy for the remainder of their pregnancy.75
Hypotension
Possible symptomatic hypotension, particularly in volume- and/or salt-depleted patients (e.g., those with restricted salt intake, treated with diuretics, undergoing dialysis, with nausea or vomiting).1
Risk of marked hypotension, sometimes associated with oliguria and azotemia, and rarely acute renal failure and death in patients with heart failure with or without associated renal insufficiency.1 Severe hypotension may result in MI or stroke in patients with ischemic heart disease, aortic stenosis, or cerebrovascular disease.1 12 34 35 36
Hypotension may occur in patients undergoing surgery or during anesthesia with agents that produce hypotension; recommended treatment is fluid volume expansion.1
To minimize potential for hypotension, consider recent antihypertensive therapy, extent of BP elevation, sodium intake, fluid status, and other clinical conditions.1 May minimize potential for hypotension by withholding diuretic therapy and/or increasing sodium intake for 2–3 days prior to initiation of moexipril.1
Transient hypotension is not a contraindication to additional doses; may reinstate therapy cautiously after BP is stabilized (e.g., with volume expansion).1
Initiate therapy in patients with heart failure (with or without associated renal insufficiency) under close medical supervision; monitor closely for first 2 weeks following initiation of moexipril or any increase in moexipril or diuretic dosage.1
Neutropenia/Agranulocytosis
Neutropenia and agranulocytosis reported with ACE inhibitors.1 83 Risk of neutropenia appears to depend principally on degree of renal impairment and presence of collagen vascular disease (e.g., systemic lupus erythematosus, scleroderma); risk with moexipril is unknown.1 83
Consider monitoring leukocytes in patients with collagen vascular disease, especially if renal impairment exists.1 83
Hepatic Effects
Clinical syndrome that usually is manifested initially by cholestatic jaundice and may progress to fulminant hepatic necrosis (occasionally fatal) reported rarely with ACE inhibitors.1
If jaundice or marked elevation of liver enzymes occurs, discontinue drug and monitor patient.1
Sensitivity Reactions
Anaphylactoid reactions and/or angioedema possible; if associated with laryngeal edema, may be fatal.1 83 Immediate medical intervention (e.g., epinephrine) required for involvement of tongue, glottis, or larynx.1 83 Intestinal angioedema possible; consider in differential diagnosis of patients who develop abdominal pain.1 83
Anaphylactoid reactions reported in patients receiving ACE inhibitors while undergoing LDL apheresis with dextran sulfate absorption1 51 52 83 or following initiation of hemodialysis that utilized high-flux membrane.1 47 48 49 83
Life-threatening anaphylactoid reactions reported in at least 2 patients receiving ACE inhibitors while undergoing desensitization treatment with hymenoptera venom.1 83
Contraindicated in patients with a history of angioedema associated with ACE inhibitors.1 83
General Precautions
Renal Effects
Inhibition of renin-angiotensin-aldosterone (RAA) system may cause renal impairment, and, rarely, acute renal failure and/or death in susceptible patients (e.g., hypertensive patients with severe heart failure).1 83
Deterioration in renal function possible in hypertensive patients with unilateral or bilateral renal artery stenosis; generally reversible following discontinuance of ACE inhibitors and/or diuretic.1 83
Closely monitor renal function for first few weeks following initiation of therapy and periodically thereafter in such patients.1 83 Some patients may require dosage reduction or discontinuance of ACE inhibitor or diuretic.1 83
Effects on Potassium
Possible hyperkalemia, especially in patients with renal impairment or diabetes mellitus and those receiving drugs that can increase serum potassium concentration (e.g., potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes).1 (See Specific Drugs under Interactions.)
Monitor serum potassium concentration carefully in these patients.1
Cough
Persistent and nonproductive cough; resolves after drug discontinuance.1
Surgery/Anesthesia
Hypotension may occur during surgery or anesthesia with agents that produce hypotension; moexipril may block the effects on compensatory renin release in such patients.1 83 May correct such hypotension by volume expansion.1 83
Use of Fixed Combinations
When moexipril is used in fixed combination with hydrochlorothiazide, consider the cautions, precautions, and contraindications associated with hydrochlorothiazide.83
Specific Populations
Pregnancy
Can cause fetal and neonatal morbidity and mortality when administered to a pregnant woman.1 83 (See Fetal/Neonatal Morbidity and Mortality under Cautions and see Boxed Warning.)
Lactation
Not known whether moexipril is distributed into milk.1 Caution advised if used in nursing women.1
Pediatric Use
If oliguria or hypotension occurs in neonates with a history of in utero exposure to moexipril, support BP and renal function; exchange transfusions or dialysis may be required.1 83 (See Fetal/Neonatal Morbidity and Mortality under Cautions.)
Safety and efficacy not established.1
Geriatric Use
Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.1 Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and potential for concomitant disease and drug therapy.1
Renal Impairment
Systemic exposure to moexipril and moexiprilat may be increased.1 Initial dosage adjustment recommended in patients with severe renal impairment.1 (See Renal Impairment under Dosage and Administration.)
Moexipril/hydrochlorothiazide fixed combination is not recommended in patients with severe renal impairment.83
Black Patients
BP reduction may be smaller in black patients compared with patients of other races.25 83 92 93 108 109 (See Hypertension under Uses.)
Higher incidence of angioedema reported with ACE inhibitors in black patients compared with other races.1 1200
Common Adverse Effects
Cough, dizziness, diarrhea, flu syndrome, fatigue, pharyngitis, flushing, rash, myalgia.1
Drug Interactions
Specific Drugs
Drug |
Interaction |
Comments |
---|---|---|
Aliskiren |
Increased risk of renal impairment, hyperkalemia, and hypotension1 83 |
Generally, avoid concomitant use; monitor BP, renal function, and electrolytes if used concomitantly1 83 |
Angiotensin II receptor antagonists |
Increased risk of renal impairment, hyperkalemia, and hypotension1 83 |
Generally, avoid concomitant use; monitor BP, renal function, and electrolytes if used concomitantly1 83 |
Anticoagulants, oral |
Clinically important interaction not observed1 |
|
Cimetidine |
Clinically important interaction not observed1 |
|
Digoxin |
Clinically important interaction not observed1 |
|
Diuretics |
Increased hypotensive effect1 |
If possible, discontinue diuretic before initiating moexipril1 (see Dosage under Dosage and Administration) |
Diuretic, potassium-sparing (amiloride, spironolactone, triamterene) |
Enhanced hyperkalemic effect1 |
Use with caution; monitor serum potassium concentrations frequently1 |
Gold |
Nitroid reactions reported rarely in patients receiving concomitant therapy with sodium aurothiomalate and an ACE inhibitor1 83 |
|
Lithium |
Increased serum lithium concentrations; possible toxicity1 |
Use with caution; monitor serum lithium concentration frequently1 |
NSAIAs (including COX-2 inhibitors) |
May result in deterioration of renal function, including possible renal failure, in geriatric patients, volume-depleted patients, or patients with compromised renal function;1 83 effects usually reversible1 83 |
|
Potassium supplements or potassium-containing salt substitutes. |
Enhanced hyperkalemic effect1 |
Use with caution; monitor serum potassium concentrations frequently1 |
Moexipril Pharmacokinetics
Absorption
Bioavailability
About 13% of oral dose is absorbed.1 Peak plasma concentration of moexiprilat is achieved within about 1.5 hours.1
Onset
Following a single oral dose, antihypertensive effects are observed within about 1 hour with peak BP reduction at 3–6 hours.1
During chronic therapy, maximum antihypertensive effect with any dose is achieved after 4 weeks.1
Duration
Antihypertensive effect of a single dose persists for about 24 hours.1
Food
Food reduces peak plasma concentration of moexipril; administer 1 hour before meals.1
Special Populations
In patients with cirrhosis, peak plasma concentration and AUC of moexipril following a single oral dose were increased, while peak plasma concentration of moexiprilat was decreased and AUC of moexiprilat was increased.1
In patients with renal impairment, increased moexipril and moexiprilat concentrations.1
Distribution
Extent
Not known whether distributed into milk.1
Plasma Protein Binding
Moexiprilat: 50%.1
Elimination
Metabolism
Metabolized in the liver, principally to an active metabolite, moexiprilat.1
Elimination Route
Following oral administration, eliminated in feces (53%), principally as moexiprilat, and to a lesser extent in urine (13%).1
Following IV administration, eliminated principally in urine, as moexiprilat (40%) and moexipril (26%), and to lesser extent in feces (about 20%, mainly as moexiprilat).1
Half-life
Moexiprilat: 12 hours.1
Special Populations
In patients with renal impairment (Clcr 10–40 mL/minute), threefold to fourfold increase in moexiprilat half-life.1
Stability
Storage
Oral
Tablets
Tight containers at 15–30°C.1
Actions
-
Prodrug; not pharmacologically active until hydrolyzed in the liver to moexiprilat.1
-
Suppresses the renin-angiotensin-aldosterone system.1
Advice to Patients
-
Risk of angioedema, anaphylactoid reactions, or other sensitivity reactions.1 Importance of reporting sensitivity reactions (e.g., edema of face, eyes, lips, tongue, or extremities; hoarseness; swallowing or breathing with difficulty) immediately to clinician and of discontinuing the drug.1
-
Risk of hypotension.1 Importance of informing clinicians promptly if lightheadedness or fainting occurs.1 Importance of adequate fluid intake; risk of volume depletion with excessive perspiration, dehydration, vomiting, or diarrhea.1
-
Importance of reporting signs of infection (e.g., sore throat, fever).1
-
Risk of hyperkalemia.1 83 Importance of avoiding use of potassium supplements or salt substitutes containing potassium without consulting a clinician.1 83
-
Importance of taking moexipril 1 hour before meals.1
-
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.1
-
Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.1 Risks of use during pregnancy; importance of discussing other options for hypertension treatment if pregnancy occurs.1 110 111
-
Importance of advising patients of other important precautionary information.1 (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Tablets, film-coated |
7.5 mg* |
Moexipril Hydrochloride Tablets |
|
15 mg* |
Moexipril Hydrochloride Tablets |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Tablets, film-coated |
7.5 mg with Hydrochlorothiazide 12.5 mg* |
Moexipril Hydrochloride and Hydrochlorothiazide Tablets |
|
15 mg with Hydrochlorothiazide 12.5 mg* |
Moexipril Hydrochloride and Hydrochlorothiazide Tablets |
|||
15 mg with Hydrochlorothiazide 25 mg* |
Moexipril Hydrochloride and Hydrochlorothiazide Tablets |
AHFS DI Essentials™. © Copyright 2024, Selected Revisions March 4, 2019. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
† Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration.
References
1. Apotex. Moexipril hydrochloride tablets prescribing information. Milwaukee, WI; 2012 Dec.
2. Dickstein K, Aarsland T, Ferrari P et al. Comparison of the efficacy of three dose levels of moexipril versus placebo as add-on therapy to hydrochlorothiazide in patients with moderate hypertension. J Cardiovasc Pharmacol. 1994; 24:247-55. http://www.ncbi.nlm.nih.gov/pubmed/7526056?dopt=AbstractPlus
3. Grass GM, Morehead WT. Evidence for site-specific absorption of a novel ACE inhibitor. Pharm Res. 1989; 6:759-65. http://www.ncbi.nlm.nih.gov/pubmed/2554270?dopt=AbstractPlus
4. White WB, Whelton A, Fox AAL et al. Tricenter assessment of the efficacy of the ACE inhibitor, moexipril, by ambulatory blood pressure monitoring. J Clin Pharmacol. 1995; 35:233-8. http://www.ncbi.nlm.nih.gov/pubmed/7608310?dopt=AbstractPlus
5. Chrysant SG, Fox AAL, Stimpel M. Comparison of moexipril, a new ACE inhibitor, to verapamil-SR as add-on therapy to low dose hydrochlorothiazide in hypertensive patients. Am J Hyperten. 1995; 8: 418-21.
6. Stimpel M, Loh IK. Moexipril versus captopril in patients with mild to moderate hypertension. Am J Hyperten. 1995; 8:183A.
7. White WB, Fox AAL, Stimpel M. Long-term efficacy and safety of moexipril in the treatment of hypertension. J Hum Hyperten. 1994; 8: 917-21.
8. Bristol-Myers Squibb Co. Capoten tablets (captopril tablets) prescribing information. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:710-4.
9. Hoechst-Roussel Pharmaceuticals Inc. Altace (ramipril) prescribing information. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:1124-6.
10. Parke Davis. Accupril (quinapril hydrochloride) tablets prescribing information. Morris Plains, NJ; 2001 Mar.
11. Merck. Prinivil (lisinopril) tablets prescribing information. Whitehouse Station, NJ; 2002 Jan.
12. Merck & Co. Vasotec tablets (enalapril maleate) prescribing information. Whitehouse Station, NJ; 2002 Jan.
13. Ciba Pharmaceutical Company. Lotensin (benazepril hydrochloride) tablets prescribing information. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:887-90.
14. Bristol-Myers Squibb. Monopril (fosinopril sodium) tablets prescribing information. Princeton, NJ; 2002 Feb.
16. Anon. Drugs for hypertension. Med Lett Drugs Ther. 1984; 26:107-12. http://www.ncbi.nlm.nih.gov/pubmed/6150424?dopt=AbstractPlus
19. Moser M. Initial treatment of adult patients with essential hypertension. Part 1: why conventional stepped-care therapy of hypertension is still indicated. Pharmacotherapy. 1985; 5:189-95. http://www.ncbi.nlm.nih.gov/pubmed/2863806?dopt=AbstractPlus
20. Kaplan NM. Initial treatment of adult patients with essential hypertension. Part 2: alternating monotherapy is the preferred treatment. Pharmacotherapy. 1985; 5:195-200. http://www.ncbi.nlm.nih.gov/pubmed/4034407?dopt=AbstractPlus
21. World Health Organization/International Society of Hypertension Fourth Mild Hypertension Conference. 1986 guidelines for the treatment of mild hypertension: memorandum from the WHO/ISH. Hypertension. 1986; 8:957-61.
22. Subcommittee on Nonpharmacological Therapy of the 1984 Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Nonpharmacological approaches to the control of high blood pressure: final report. Hypertension. 1986; 8:444-67. http://www.ncbi.nlm.nih.gov/pubmed/3009327?dopt=AbstractPlus
23. The Expert Panel (coordinated by the National Heart, Lung, and Blood Institute). Report of the Joint National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Arch Intern Med. 1988; 148:36-69. http://www.ncbi.nlm.nih.gov/pubmed/3422148?dopt=AbstractPlus
25. Alderman MH. Which antihypertensive drugs first—and why! JAMA. 1992; 267:2786-7. Editorial.
26. Weber MA, Laragh JH. Hypertension: steps forward and steps backward: the Joint National Committee fifth report. Arch Intern Med. 1993; 153:149-52. http://www.ncbi.nlm.nih.gov/pubmed/8422205?dopt=AbstractPlus
27. Weber MA, Laragh JH. Hypertension: steps forward and steps backward: the Joint National Committee fifth report. Arch Intern Med. 1993; 153:149-52. http://www.ncbi.nlm.nih.gov/pubmed/8422205?dopt=AbstractPlus
28. Andrèn L, Weiner L, Svensson A et al. Enalapril with either a “very low” or “low” dose of hydrochlorothiazide is equally effective in essential hypertension: a double-blind trial in 100 hypertensive patients. J Hypertens. 1983; 1(Suppl 2):384-6.
29. Bauer JH, Jones LB. Comparative studies: enalapril versus hydrochlorothiazide as first-step therapy for the treatment of primary hypertension. Am J Kidney Dis. 1984; 4:55-64. http://www.ncbi.nlm.nih.gov/pubmed/6331157?dopt=AbstractPlus
30. Vlasses PH, Rotmensch HH, Swanson BN et al. Comparative antihypertensive effects of enalapril maleate and hydrochlorothiazide, alone and in combination. J Clin Pharmacol. 1983; 23:227-33. http://www.ncbi.nlm.nih.gov/pubmed/6308068?dopt=AbstractPlus
31. Fernandez PG, Kim BK, Galway AB. An appraisal of antihypertensive efficacy and adverse reactions with two drug regimens: enalapril maleate as part of triple therapy compared to conventional triple therapy in moderate to severe hypertension. Pharmatherapeutica. 1984; 3:505-14. http://www.ncbi.nlm.nih.gov/pubmed/6322207?dopt=AbstractPlus
32. Guthrie GP Jr, Hammond J, Kotchen TA. Abrupt cessation of enalapril (MK-421) in essential hypertension. Clin Res. 1982; 30:733A.
33. Edling O, Gohlke P, Bao G et al. In vitro and in vivo characterization of the new ACE inhibitor moexipril: comparison with enalapril. Naunyn Schmiedebergs Arch Pharmacol. 1993; 347:R95. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3437322&blobtype=pdf
34. DiCarlo L, Chatterjee K, Parmley WW et al. Enalapril: a new angiotensin-converting enzyme inhibitor in chronic heart failure: acute and chronic hemodynamic evaluations. J Am Coll Cardiol. 1983; 2:865-71. http://www.ncbi.nlm.nih.gov/pubmed/6313787?dopt=AbstractPlus
35. Packer M, Lee WH, Yushak M et al. Comparison of captopril and enalapril in patients with severe chronic heart failure. N Engl J Med. 1986; 315:847-53. http://www.ncbi.nlm.nih.gov/pubmed/3018566?dopt=AbstractPlus
36. The Consensus Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the cooperative North Scandinavian enalapril survival study (consensus). N Engl J Med. 1987; 316:1429-34. http://www.ncbi.nlm.nih.gov/pubmed/2883575?dopt=AbstractPlus
37. Anon. Enalapril for hypertension. Med Lett Drugs Ther. 1986; 28:53-4. http://www.ncbi.nlm.nih.gov/pubmed/3010064?dopt=AbstractPlus
38. Hodsman GP, Brown JJ, Cumming AMM et al. Enalapril in the treatment of hypertension with renal artery stenosis. BMJ. 1983; 287:1413-7. http://www.ncbi.nlm.nih.gov/pubmed/6315126?dopt=AbstractPlus
39. Hodsman GP, Brown JJ, Cumming AMM et al. Enalapril in treatment of hypertension with renal artery stenosis: changes in blood pressure, renin, angiotensin I and II, renal function, and body composition. Am J Med. 1984; 77:52-60.
40. Bender W, La France N, Walker WG. Mechanism of deterioration in renal function in patients with renovascular hypertension treated with enalapril. Hypertension. 1984; 6(Suppl 1):I193-7. http://www.ncbi.nlm.nih.gov/pubmed/6327522?dopt=AbstractPlus
41. Hricik DE, Browning PJ, Kopelman R et al. Captopril-induced renal insufficiency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney. N Engl J Med. 1983; 308:373-6. http://www.ncbi.nlm.nih.gov/pubmed/6337327?dopt=AbstractPlus
42. Todd PA, Heel RC. Enalapril: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and congestive heart failure. Drugs. 1986; 31:198-248. http://www.ncbi.nlm.nih.gov/pubmed/3011386?dopt=AbstractPlus
43. Packler M, Lee WH, Medina M et al. Functional renal insufficiency during long-term therapy with captopril and enalapril in severe chronic heart failure. Ann Intern Med. 1987; 106:346-54. http://www.ncbi.nlm.nih.gov/pubmed/3028221?dopt=AbstractPlus
44. Cody RJ. Clinical and hemodynamic experience with enalapril in congestive heart failure. Am J Cardiol. 1985; 55:36-40.
45. Packer M, Lee WH, Kessler PD. Preservation of glomerular filtration rate in human heart failure by activation of the renin-angiotensin system. Circulation. 1986; 74:766-74. http://www.ncbi.nlm.nih.gov/pubmed/3019586?dopt=AbstractPlus
46. Packer M, Kessler PD, Gottlieb SS. Adverse effects of converting-enzyme inhibition in patients with severe congestive heart failure: pathophysiology and management. Postgrad Med J. 1986; 62(Suppl 1):179-82. http://www.ncbi.nlm.nih.gov/pubmed/3022272?dopt=AbstractPlus
47. US Food and Drug Administration. Severe allergic reactions associated with dialysis and ACE inhibitors. FDA Med Bull. 1992; 22:4.
48. Parnes EL, Shapiro WB. Anaphylactoid reactions in hemodialysis patients treated with the AN69 dialyzer. Kidney Int. 1991; 40:1148-52. http://www.ncbi.nlm.nih.gov/pubmed/1762316?dopt=AbstractPlus
49. Tielemans C, Madhoun P, Lenaers M et al. Anaphylactoid reactions during hemodialysis on AN69 membranes in patients receiving ACE inhibitors. Kidney Int. 1990; 38:982-4. http://www.ncbi.nlm.nih.gov/pubmed/2266684?dopt=AbstractPlus
50. Agishi T. Anion-blood contact reaction (ABC reaction) in patients treated by LDL apheresis with dextran sulfate–cellulose column while receiving ACE inhibitors. JAMA. 1994; 271:195-6. http://www.ncbi.nlm.nih.gov/pubmed/7695665?dopt=AbstractPlus
51. Olbricht CJ, Schaumann D, Fischer D. Anaphylactoid reactions, LDL apheresis with dextran sulphate, and ACE inhibitors. Lancet. 1992; 340:908-9. http://www.ncbi.nlm.nih.gov/pubmed/1357312?dopt=AbstractPlus
52. Keller C, Grützmacher P, Bahr F et al. LDL-apheresis with dextran sulphate and anaphylactoid reactions to ACE inhibitors. Lancet. 1993; 341:60-1. http://www.ncbi.nlm.nih.gov/pubmed/8093314?dopt=AbstractPlus
53. Merck & Co. Vaseretic (enalapril maleate–hydrochlorothiazide) prescribing information. West Point, PA; 1994 Feb.
54. Merck & Co. Vasotec I.V. Enalaprilat (enalapril) prescribing information. West Point, PA; 1994 Apr.
55. Heel RC, Brogden RN, Speight TM et al. Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs. 1980; 20:409-52. http://www.ncbi.nlm.nih.gov/pubmed/7009133?dopt=AbstractPlus
56. Ferguson RK, Vlasses PH. Clinical pharmacology and therapeutic applications of the new oral angiotensin converting enzyme inhibitor, captopril. Am Heart J. 1981; 101:650-6. http://www.ncbi.nlm.nih.gov/pubmed/6261570?dopt=AbstractPlus
57. Frohlich ED, Cooper RA, Lewis EJ. Review of the overall experience of captopril in hypertension. Arch Intern Med. 1984; 144:1441-4. http://www.ncbi.nlm.nih.gov/pubmed/6233948?dopt=AbstractPlus
58. Vlasses PH, Larijani GE, Conner DP et al. Enalapril, a nonsulfhydryl angiotensin-converting enzyme inhibitor. Clin Pharm. 1985; 4:27-40. http://www.ncbi.nlm.nih.gov/pubmed/2982541?dopt=AbstractPlus
59. Bünning P. Inhibition of angiotensin converting enzyme by 2-[N-[(S)-1-carboxy-3-phenylpropyl]-l -alanyl]- (1S,3S,5S)-2-azabicyclo[3.3.0]octane-3-carboxylic acid (Hoe 498 Diacid). Arzneimittelforschung. 1984; 34:1406-10. http://www.ncbi.nlm.nih.gov/pubmed/6097266?dopt=AbstractPlus
60. Gavras H, Waeber B, Gavras I et al. Antihypertensive effect of the new oral angiotensin converting enzyme inhibitor MK-421. Lancet. 1981; 2:543-7. http://www.ncbi.nlm.nih.gov/pubmed/6116000?dopt=AbstractPlus
61. Reviewers’ comments (personal observations) on enalapril; 1986 Nov.
62. Semple PF, Herd GW. Cough and wheeze caused by inhibitors of angiotensin-converting enzyme. N Engl J Med. 1986; 314:61. http://www.ncbi.nlm.nih.gov/pubmed/2999601?dopt=AbstractPlus
63. Sesoko S, Kaneko Y. Cough associated with the use of captopril. Arch Intern Med. 1985; 145:1524. http://www.ncbi.nlm.nih.gov/pubmed/3896184?dopt=AbstractPlus
64. Webb D, Benjamin N, Collier J et al. Enalapril-induced cough. Lancet. 1986; 2:1094. http://www.ncbi.nlm.nih.gov/pubmed/2877240?dopt=AbstractPlus
65. Inman WHW. Enalapril-induced cough. Lancet. 1986; 2:1218.
66. Israel-Biet D, Delaisements C, Chretien J. Enalapril-induced cough. Lancet. 1986; 2:918. http://www.ncbi.nlm.nih.gov/pubmed/2876346?dopt=AbstractPlus
67. Fennerty A, Littley M, Reid P. Enalapril-induced nasal blockage. Lancet. 1986; 2:1395-6. http://www.ncbi.nlm.nih.gov/pubmed/2878252?dopt=AbstractPlus
68. Nicholls MG, Gilchrist N. Sulindac and cough induced by converting enzyme inhibitors. Lancet. 1987; 1:872. http://www.ncbi.nlm.nih.gov/pubmed/2882285?dopt=AbstractPlus
69. Anon. Captopril: benefits and risks in severe hypertension. Lancet. 1980; 2:129-30. http://www.ncbi.nlm.nih.gov/pubmed/6105297?dopt=AbstractPlus
70. Vlasses PH, Ferguson RK, Chatterjee K. Captopril: clinical pharmacology and benefit-to-risk ratio in hypertension and congestive heart failure Pharmacotherapy. 1982; 2:1-17.
71. Waeber B, Gavras I, Brunner HR et al. Safety and efficacy of chronic therapy with captopril in hypertensive patients: an update. J Clin Pharmacol. 1981; 21:508-16. http://www.ncbi.nlm.nih.gov/pubmed/6460791?dopt=AbstractPlus
72. Fruncillo RJ, Rocci ML Jr, Shepley K et al. Enalaprilat accumulates after chronic enalapril dosing in renal failure. Clin Pharmacol Ther. 1985; 37:197.
73. Schubiger G, Flury G, Nussberger J. Enalapril for pregnancy-induced hypertension: acute renal failure in a neonate. Ann Intern Med. 1988; 108:215-6. http://www.ncbi.nlm.nih.gov/pubmed/2829674?dopt=AbstractPlus
74. Joint letter of Bristol-Myers Squibb Company; Ciba-Geigy Corporation, Pharmaceutical Division; Hoechst-Roussel Pharmaceuticals Inc; ICI Pharmaceutical Group, ICI Americas Inc; Merck Human Health Division; Parke-Davis, Division of Warner-Lambert Company. Important warning information regarding use of ACE inhibitors in pregnancy. 1992 Mar 16.
75. US Food and Drug Administration. Dangers of ACE inhibitors during second and third trimesters of pregnancy. FDA Med Bull. 1992; 22:2.
76. Piper JM, Ray WA, Rosa FW. Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors. Obstet Gynecol. 1992; 80:429-32. http://www.ncbi.nlm.nih.gov/pubmed/1495700?dopt=AbstractPlus
77. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991; 325:293-302. http://www.ncbi.nlm.nih.gov/pubmed/2057034?dopt=AbstractPlus
78. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992; 327:685-91. http://www.ncbi.nlm.nih.gov/pubmed/1463530?dopt=AbstractPlus
79. Anon. ACE-inhibitors: contraindicated in pregnancy. WHO Drug Information. 1990; 4:23.
80. Scott AA, Purohit DM. Neonatal renal failure: a complication of maternal antihypertensive therapy. Am J Obstet Gynecol. 1989; 160:1223-4. http://www.ncbi.nlm.nih.gov/pubmed/2543224?dopt=AbstractPlus
81. Bennett WM, Aronoff GR, Golper TA et al. Drug prescribing in renal failure: dosing guidelines for adults. Philadelphia: American College of Physicians; 1987:36-7.
82. Varonier HS, Panzani R. The effect of inhalations of bradykinin on healthy and atopic (asthmatic) children. Int Arch Allergy Appl Immunol. 1968; 34:293-6. http://www.ncbi.nlm.nih.gov/pubmed/5681106?dopt=AbstractPlus
83. Heritage Pharmaceuticals Inc. Uniretic Moexipril hydrochloride and hydrochlorothiazide tablets prescribing information. Eatontown, NJ; 2016 Nov.
84. Whelton PK, Appel LJ, Espeland MA et al. for the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46. http://www.ncbi.nlm.nih.gov/pubmed/9515998?dopt=AbstractPlus
85. Food and Drug Administration. Univasc (moexipril hydrochloride) tablets [February 2, 2000: Schwarz]. MedWatch drug labeling changes. Rockville, MD; February 2000. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/
87. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. http://www.ncbi.nlm.nih.gov/pubmed/10818056?dopt=AbstractPlus
88. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. http://www.ncbi.nlm.nih.gov/pubmed/10818055?dopt=AbstractPlus
89. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. http://www.ncbi.nlm.nih.gov/pubmed/10977801?dopt=AbstractPlus
90. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. http://www.diabetes.org
91. Schoolwerth AC, Sica DA, Ballermann BJ et al. Renal considerations in angiotensin converting enzyme inhibitor therapy: a statement for healthcare professionals from the Council on the Kidney in Cardiovascular Disease and the Council for High Blood Pressure Research of the American Heart Association. Circulation. 2001; 104:1985-91. http://www.ncbi.nlm.nih.gov/pubmed/11602506?dopt=AbstractPlus
92. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-60. http://www.ncbi.nlm.nih.gov/pubmed/12479770?dopt=AbstractPlus
93. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. http://www.ncbi.nlm.nih.gov/pubmed/12479763?dopt=AbstractPlus
96. AstraZeneca. Zestril (lisinopril) tablets prescribing information. Wilmington, DE: 2002 Jan.
99. Novartis. Diovan (valsartan) tablets prescribing information. East Hanover, NJ; 2002 Aug.
103. Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1993; 329:1456-62. http://www.ncbi.nlm.nih.gov/pubmed/8413456?dopt=AbstractPlus
104. Remuzzi G. Slowing the progression of diabetic nephropathy. N Engl J Med. 1993; 329:1496-7. http://www.ncbi.nlm.nih.gov/pubmed/8413463?dopt=AbstractPlus
105. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. http://www.ncbi.nlm.nih.gov/pubmed/8622249?dopt=AbstractPlus
106. Viberti G, Mogensen CE, Groop LC et al. Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria. JAMA. 1994; 271:275-9. http://www.ncbi.nlm.nih.gov/pubmed/8295285?dopt=AbstractPlus
107. Fournier A. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1994; 330:937. http://www.ncbi.nlm.nih.gov/pubmed/8114873?dopt=AbstractPlus
108. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:1595-607. http://www.ncbi.nlm.nih.gov/pubmed/15811979?dopt=AbstractPlus
109. Neaton JD, Kuller LH. Diuretics are color blind. JAMA. 2005; 293:1663-6. Editorial. http://www.ncbi.nlm.nih.gov/pubmed/15811986?dopt=AbstractPlus
110. Cooper WO, Hernandez-Diaz S, Arbogast PG et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006; 354:2443-51. http://www.ncbi.nlm.nih.gov/pubmed/16760444?dopt=AbstractPlus
111. Food and Drug Administration. FDA public health advisory: angiotensin-converting enzyme inhibitor (ACE inhibitor) drugs and pregnancy. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/PublicHealthAdvisories/ucm053113.htm
112. Schwarz Pharma, Milwaukee, WI: Personal communication.
501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. http://www.ncbi.nlm.nih.gov/pubmed/24352797?dopt=AbstractPlus
502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. http://www.ncbi.nlm.nih.gov/pubmed/23817082?dopt=AbstractPlus
503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. http://www.ncbi.nlm.nih.gov/pubmed/24243703?dopt=AbstractPlus
504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. http://www.ncbi.nlm.nih.gov/pubmed/24341872?dopt=AbstractPlus
505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. http://www.ncbi.nlm.nih.gov/pubmed/24424788?dopt=AbstractPlus
506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. http://www.ncbi.nlm.nih.gov/pubmed/24549531?dopt=AbstractPlus
507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. http://www.ncbi.nlm.nih.gov/pubmed/24352710?dopt=AbstractPlus
508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. http://www.ncbi.nlm.nih.gov/pubmed/24352759?dopt=AbstractPlus
511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. http://www.ncbi.nlm.nih.gov/pubmed/19139601?dopt=AbstractPlus
515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. http://www.ncbi.nlm.nih.gov/pubmed/24591473?dopt=AbstractPlus
523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471. http://www.ncbi.nlm.nih.gov/pubmed/23166211?dopt=AbstractPlus
524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327. http://www.ncbi.nlm.nih.gov/pubmed/23741058?dopt=AbstractPlus
525. Smith SC, Benjamin EJ, Bonow RO et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011; 124:2458-73. http://www.ncbi.nlm.nih.gov/pubmed/22052934?dopt=AbstractPlus
526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. http://www.ncbi.nlm.nih.gov/pubmed/24788967?dopt=AbstractPlus
527. O'Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362-425. http://www.ncbi.nlm.nih.gov/pubmed/23247304?dopt=AbstractPlus
530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. http://www.ncbi.nlm.nih.gov/pubmed/24641124?dopt=AbstractPlus
534. Qaseem A, Hopkins RH, Sweet DE et al. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013; 159:835-47. http://www.ncbi.nlm.nih.gov/pubmed/24145991?dopt=AbstractPlus
535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. http://www.ncbi.nlm.nih.gov/pubmed/23684145?dopt=AbstractPlus
536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl.. 2012; 2:337-414.
541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. http://www.ncbi.nlm.nih.gov/pubmed/22555213?dopt=AbstractPlus
543. National Kidney Foundation Kidney Disease Outcomes Quality Initiative. K/DOQI Clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease (2002). From National Kidney Foundation website. http://www.kidney.org/professionals/kdoqi/guidelines_commentaries.cfm
701. Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016; 37:2129-200. http://www.ncbi.nlm.nih.gov/pubmed/27206819?dopt=AbstractPlus
702. McMurray JJ, Packer M, Desai AS et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014; 371:993-1004. http://www.ncbi.nlm.nih.gov/pubmed/25176015?dopt=AbstractPlus
703. Ansara AJ, Kolanczyk DM, Koehler JM. Neprilysin inhibition with sacubitril/valsartan in the treatment of heart failure: mortality bang for your buck. J Clin Pharm Ther. 2016; 41:119-27. http://www.ncbi.nlm.nih.gov/pubmed/26992459?dopt=AbstractPlus
800. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016; 134:e282-93. http://www.ncbi.nlm.nih.gov/pubmed/27208050?dopt=AbstractPlus
801. Saunders E. Tailoring treatment to minority patients. Am J Med. 1990; 88(Suppl 3B):21-3S. http://www.ncbi.nlm.nih.gov/pubmed/2294761?dopt=AbstractPlus
802. Chrysant SG, Danisa K, Kem DC et al. Racial differences in pressure, volume and renin interrelationships in essential hypertension. Hypertension. 1979; 1:136-41. http://www.ncbi.nlm.nih.gov/pubmed/399939?dopt=AbstractPlus
803. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-42. http://www.ncbi.nlm.nih.gov/pubmed/12479770?dopt=AbstractPlus
804. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97.
805. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:1595-607. http://www.ncbi.nlm.nih.gov/pubmed/15811979?dopt=AbstractPlus
806. Neaton JD, Kuller LH. Diuretics are color blind. JAMA. 2005; 293:1663-6. http://www.ncbi.nlm.nih.gov/pubmed/15811986?dopt=AbstractPlus
1150. Flynn JT, Kaelber DC, Baker-Smith CM et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017; 140 http://www.ncbi.nlm.nih.gov/pubmed/28827377?dopt=AbstractPlus
1200. Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; 71:el13-e115. http://www.ncbi.nlm.nih.gov/pubmed/29133356?dopt=AbstractPlus
1201. Bakris G, Sorrentino M. Redefining hypertension - assessing the new blood-pressure guidelines. N Engl J Med. 2018; 378:497-499. http://www.ncbi.nlm.nih.gov/pubmed/29341841?dopt=AbstractPlus
1202. Carey RM, Whelton PK, 2017 ACC/AHA Hypertension Guideline Writing Committee. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association hypertension guideline. Ann Intern Med. 2018; 168:351-358. http://www.ncbi.nlm.nih.gov/pubmed/29357392?dopt=AbstractPlus
1207. Burnier M, Oparil S, Narkiewicz K et al. New 2017 American Heart Association and American College of Cardiology guideline for hypertension in the adults: major paradigm shifts, but will they help to fight against the hypertension disease burden?. Blood Press. 2018; 27:62-65. http://www.ncbi.nlm.nih.gov/pubmed/29447001?dopt=AbstractPlus
1209. Qaseem A, Wilt TJ, Rich R et al. Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017; 166:430-437. http://www.ncbi.nlm.nih.gov/pubmed/28135725?dopt=AbstractPlus
1210. SPRINT Research Group, Wright JT, Williamson JD et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015; 373:2103-16. http://www.ncbi.nlm.nih.gov/pubmed/26551272?dopt=AbstractPlus
1213. Reboussin DM, Allen NB, Griswold ME et al. Systematic review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71:2176-2198. http://www.ncbi.nlm.nih.gov/pubmed/29146534?dopt=AbstractPlus
1214. American Diabetes Association. 9. Cardiovascular disease and risk management: standards of medical care in diabetes 2018. Diabetes Care. 2018; 41:S86-S104. http://www.ncbi.nlm.nih.gov/pubmed/29222380?dopt=AbstractPlus
1215. de Boer IH, Bangalore S, Benetos A et al. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017; 40:1273-1284. http://www.ncbi.nlm.nih.gov/pubmed/28830958?dopt=AbstractPlus
1216. Taler SJ. Initial treatment of hypertension. N Engl J Med. 2018; 378:636-644. http://www.ncbi.nlm.nih.gov/pubmed/29443671?dopt=AbstractPlus
1218. Messerli FH, Bangalore S, Bavishi C et al. Angiotensin-converting enzyme inhibitors in hypertension: to use or not to use?. J Am Coll Cardiol. 2018; 71:1474-1482. http://www.ncbi.nlm.nih.gov/pubmed/29598869?dopt=AbstractPlus
1220. Cifu AS, Davis AM. Prevention, detection, evaluation, and management of high blood pressure in adults. JAMA. 2017; 318:2132-2134. http://www.ncbi.nlm.nih.gov/pubmed/29159416?dopt=AbstractPlus
1222. Bell KJL, Doust J, Glasziou P. Incremental benefits and harms of the 2017 American College of Cardiology/American Heart Association high blood pressure guideline. JAMA Intern Med. 2018; 178:755-7. http://www.ncbi.nlm.nih.gov/pubmed/29710197?dopt=AbstractPlus
1223. LeFevre M. ACC/AHA hypertension guideline: what is new? what do we do?. Am Fam Physician. 2018; 97(6):372-3. http://www.ncbi.nlm.nih.gov/pubmed/29671534?dopt=AbstractPlus
1224. Brett AS. New hypertension guideline is released. From NEJM Journal Watch website. Accessed 2018 Jun 18. https://www.jwatch.org/na45778/2017/12/28/nejm-journal-watch-general-medicine-year-review-2017
1229. Ioannidis JPA. Diagnosis and treatment of hypertension in the 2017 ACC/AHA guidelines and in the real world. JAMA. 2018; 319(2):115-6. http://www.ncbi.nlm.nih.gov/pubmed/29242891?dopt=AbstractPlus
1232. American Diabetes Association. 10. Microvascular complications and foot care: standards of medical care in diabetes 2018. Diabetes Care. 2018; 41:S105-S118. http://www.ncbi.nlm.nih.gov/pubmed/29222381?dopt=AbstractPlus
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