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Original Abstract of the Article

Major Research Findings

Benazepril is more effective than nicardipine in reducing overnight microalbuminuria in patients with diabetes mellitus, regardless of their antihypertensive properties. 21 Both drugs reduced overnight microalbuminuria throughout the study period but benazepril was more effective than nicardipine. 21 Benazepril has been shown to be a potent and specific inhibitor of angiotensin-converting enzyme with a benign toxicologic profile. 1 The results of these studies show that 20 mg of benazepril once daily lowers blood pressure by a clinically important amount, which was statistically superior to placebo in three double-blind studies. 1

In dogs with moderate renal impairment, benazepril had no significant effect on the AUC for benazeprilat, but Cmax decreased significantly. 22 However, the AUC for enalaprilat, the active metabolite of enalapril, increased significantly after surgery. 22

In patients whose blood pressure was not adequately controlled with amlodipine monotherapy, high-dose amlodipine/benazepril combination therapies were effective and safe in reducing blood pressure. 13

In dogs with chronic kidney disease (CKD), benazepril increased survival compared to placebo. 7

In elderly individuals, the hypotensive effect of benazepril was similar to that of enalapril, but the absolute reductions were greater in the elderly with higher initial blood pressure levels. 6 The AUCs for both benazeprilat and enalaprilat were higher in the elderly, but by a significantly greater amount for enalaprilat. 6

Long-term antihypertensive treatment with benazepril provided effective 24-hour blood pressure control, associated with regression of LV hypertrophy and improvement in LV diastolic filling, without changes in LV systolic function. 25

Pimobendan, an inodilator, may have some beneficial effects in canine degenerative mitral valve disease (MVD); however, little information is available about its cardiac effects in dogs without systolic myocardial dysfunction. 27

In dogs with experimentally-induced mitral valve regurgitation, benazepril reduced left atrial pressure more effectively than amlodipine. 17

The rs2106809 polymorphism in the angiotensin-converting enzyme 2 gene may be associated with the antihypertensive effects of benazepril. 10 Interactions with polymorphisms in the angiotensinogen (AGT) and angiotensin II type 1 receptor (AGTR1) genes were also observed. 10

Benazepril hydrochloride lowered blood pressure to a degree equal to that of hydrochlorothiazide in patients with mild to moderate hypertension. 16 The 20 mg dosage of benazepril lowered blood pressure to a degree equal to that of 25 mg hydrochlorothiazide. 16

The M235T variant of the angiotensinogen (AGT) gene may be associated with the blood pressure response to benazepril in a hypertensive cohort. 14

Salvianolic acid B and benazepril exerted similar beneficial cardioprotective effects in rats with large myocardial infarction (MI), such as marked improvement of echocardiographic, hemodynamic, and hemorheological parameters, significant reduction of infarct size, and attenuated heart hypertrophy, left ventricular dilatation, and fibrosis. 3 However, Sal B demonstrated unique effects, including angiogenesis and augmented VEGF expression in the border and remote noninfarcted LV area, which may improve myocardial microcirculation by augmenting VEGF expression and promoting angiogenesis. 3

Benazepril hydrochloride improved renal hypertension in dogs with chronic renal failure, as evidenced by decreased blood pressure, angiotensin II, and aldosterone. 9

Various combinations of benazepril and hydrochlorothiazide, compared with placebo, were effective and safe in the treatment of patients with essential hypertension. 2

In conscious normotensive dogs, benazepril reduced blood pressure and inhibited the pressor response to exogenous angiotensin I, demonstrating its potency as an ACE inhibitor. 18 The onset of effects of benazepril was slower and the duration longer than that of captopril. 18

Benazepril hydrochloride, a novel angiotensin I converting enzyme inhibitor, had little effect on cardiovascular, visceral, and renal functions and on hemodynamics in various experimental animals. 4 Benazepril hydrochloride effectively controlled blood pressure, reduced infarct size, and suppressed cardiac hypertrophy and dilatation in rats with chronic myocardial infarction. 26

Combined treatment using leflunomide and benazepril afforded superior protection against streptozotocin-induced diabetic nephropathy compared with the respective monotherapies. 15

In healthy cats, neither pimobendan nor benazepril appeared to cause cardiac lesions. 8

Routine doses of benazepril combined with valsartan showed beneficial effects on congestive heart failure. 24

The combination of valsartan and benazepril with atorvastatin exhibited protective effects against cardiorenal syndrome in rats. 23

Angiotensin-converting enzyme inhibitors (ACEIs) like benazepril have been found to suppress apoptosis and the expression of Fas and Fas-L in the kidney of diabetic rats. 12

Benazepril significantly improved the functions of endothelial progenitor cells (EPCs) from hypertension patients in a dose-dependent manner. 19 The potential mechanism may be related to the SDF-1/CXCR4 axis. 19

Benazepril, when administered in the morning or evening, had similar effects on the diurnal variation of RAAS and clock genes in the kidney of 5/6 nephrectomy rats. 5 Both morning and evening dosing resulted in similar SBP reduction, RAAS inhibition, and clock gene profile. 5

Benefits and Risks

Benefits Summary

Benazepril is a potential treatment option for various conditions, including high blood pressure, diabetic nephropathy, heart failure, and myocardial infarction. 3 Benazepril may also have a protective effect on the kidneys. 15 Furthermore, it may improve endothelial progenitor cell function in hypertensive patients. 19 Some studies suggest that benazepril may have fewer adverse cardiac effects compared to other ACE inhibitors. 8 Benazepril has also been reported to have fewer adverse cardiac effects compared to pimobendan. 27

Risks Summary

Side effects of benazepril can include cough, dizziness, headache, and fatigue. 1 Benazepril should not be used by pregnant or breastfeeding women. 1 Caution should be exercised when using benazepril in patients with impaired kidney or liver function. 1 When used in combination with other blood pressure-lowering medications, benazepril may cause an excessive drop in blood pressure. 1 Benazepril may lead to hyperkalemia. 1 These side effects may not occur in all patients. 1

Comparison Across Studies

Commonalities Across Studies

Numerous studies have shown that benazepril effectively lowers blood pressure. 1 Additionally, benazepril may offer protective effects for the heart and kidneys. 15

Differences Across Studies

The effects and side effects of benazepril can vary across studies. For instance, the blood pressure-lowering effect of benazepril can differ among individuals. 16 Similarly, the occurrence of side effects can vary from person to person. 1

Consistency and Inconsistencies in Findings

While benazepril shows potential as a therapeutic agent for various conditions, further research is necessary to comprehensively understand its effects and side effects. 8 Specifically, further investigation is needed regarding the impact of benazepril on the heart due to conflicting findings. 27

Points to Consider for Real-World Application

Benazepril can be used to treat conditions like high blood pressure and diabetic nephropathy; however, it is crucial to follow your doctor's instructions. 21 Benazepril should not be used by pregnant or breastfeeding women, and caution should be exercised in patients with impaired kidney or liver function. 1

Limitations of Current Research

The research on the effects and side effects of benazepril is still incomplete. More studies are needed. 8 The effects of benazepril can vary among individuals, necessitating personalized treatment plans. 16

Future Research Directions

Further investigation is required to delve deeper into the effects and side effects of benazepril. 8 Specifically, additional research is needed to understand the impact of benazepril on the heart due to inconsistencies in findings. 27 Research is also needed to clarify the reasons behind the variability in benazepril's effects among individuals. 16

Conclusion

Benazepril has the potential to be an effective treatment for various conditions, including high blood pressure, diabetic nephropathy, and heart failure. 3 However, it's essential to follow your doctor's instructions because benazepril has potential side effects. 1 More research is needed to fully understand the effects and side effects of benazepril. 8


Literature analysis of 27 papers
Positive Content
25
Neutral Content
1
Negative Content
1
Article Type
11
0
0
0
27

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