Antiremodelling Efficacy and Clinical Safety of Zofenopril in Patients with Grade 1and 2 Hypertension

Gulnoz A. Khamidullaeva, PhD, ScD; Guzal J. Abdullaeva, PhD; Lola Sh. Khafizova, PhD; Nigora Z. Srojidinova, PhD; Nigora B. Tursunova, PhD; Dilorom R. Kurbanova, PhD, ScD; Nodira Sh. Shakirova, PhD

The Republican Specialized Center of Cardiology; Tashkent, Uzbekistan

*Corresponding author: Nigora Z. Srojidinova, PhD. The Republican Specialized Center of Cardiology; Tashkent, Uzbekistan. E-mail:

Published: December 3, 2015. DOI: 10.21103/Article5(4)_OA6


Objective: to estimate the antihypertensive, antiremodelling efficacy and clinical tolerability of the monotherapy with Zofenopril in patients with Grade 1 and 2 hypertension (HT 1 and 2)

 Materials and Methods: The study included 30 patients aged from 30 to 60 years with HT 1 and 2 (ESH/ESC, 2013) without severe comorbidities and cardiovascular complications. Zofenopril was prescribed as monotherapy to HT patients who had never been treated before or patients after one week of lavage from previous antihypertensive therapy, who did not reach target levels of BP. Before and during treatment all patients were checked on office BP using Korotkov’s method and ambulatory blood pressure monitoring (ABPM). Echocardiography and Doppler sonography were carried out by standard methods using the recommendations of the American Society of Echocardiography. Intima-media thickness (IMT) of the carotid artery and brachial artery was measured by a 7.5MHz high-resolution ultrasound. Assessment of flow-mediated dilation (FMD) of the brachial artery was used as a method of determining endothelial function.

Results: A 12-week monotherapy with Zofenopril in average daily dose of 36.0±19.54 mg showed a high antihypertensive efficacy and a good safety profile without side effects. We noted a reliable decrease in systolic BP (SBP), diastolic BP (DBP), mean BP, and pulse pressure (PP) by -19.53±5.93%, -18.64±7.18%, BP -19.05±6.14%, and -20.65±12.07%, respectively. Target SBP, DBP, and SBP+DBP were reached in 90%, 86.6%, and 83.3% of patients, respectively. We found a significant regression of LVH, significant improvement in volume indicators of LV echogeometry and parameters of FMD of the brachial artery, as well as a decrease in IMT of carotid and brachial arteries. Monotherapy with Zofenopril showed metabolic neutrality regarding the lipid and carbohydrate metabolism, a good safety profile without the side effects and undesired events.

Grade 1 and 2 hypertension; Zofenopril; antihypertensive efficacy; organprotective effects
  1. Pasini AF, Garbin U, Nava MC. Stranieri C, Pellegrini M, Boccioletti V, et al. Effect of sulfhydryl and non-sulfhydryl angiotensin-converting enzyme inhibitors on endothelial function in essential hypertensive patients. Am J Hypertens. 2007; 20(4):443-50.
  2. Evangelista S, Manzini S. Antioxidant and cardiopritective properties of the sulfhydryl angiotensin-converting enzyme inhibitor zofenopril. J Int Med Res. 2005; 33(1):42-54.
  3. Ambrosioni E. Defining the role of zofenopril in the management of hypertension and ischemic heart disorders. Am J Cardiovasc Drugs. 2007; 7(1):17-24.
  4. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, 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). Eur Heart J. 2013;34(28):2159-219.
  5. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977;55(4):613-8.
  6. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet.1992; 340(8828):1111-1115.   
  7. Nilsson P.  Antihypertensive efficacy of zofenopril compared with atenolol in patients with mild to moderate hypertension. Blood Press Suppl. 2007 Oct;2:25-30.
  8. Mallion JM. An evaluation of the initial and long-term antihypertensive efficacy of zofenopril compared with enalapril in mild to moderate hypertension. Blood Press Suppl. 2007 Oct;2:13-8.
  9. Napoli C, Bruzzese G, Ignarro LJ, Crimi E, de Nigris F, Williams-Ignarro S, et al. Long-term treatment with sulfhydryl angiotensin-converting enzyme inhibition reduces carotid intima-media thickening and improves the nitric oxide/oxidative stress pathways in newly diagnosed patients with mild to moderate primary hypertension. Am Heart J. 2008 Dec;156(6):1154.e1-8.
  10. Borghi C, Bacchelli S, Esposti DD, Bignamini A, Magnani B, Ambrosioni E. Effects of the administration of an angiotensin-converting enzyme inhibitor during the acute phase of myocardial infarction in patients with arterial hypertension. SMILE Study Investigators. Survival of Myocardial Infarction Long-term Evaluation. Am J Hypertens. 1999;12(7):665-72.
  11. Borghi C, Ambrosioni E, Omboni S, Cicero AF, Bacchelli S, Esposti DD,et al. Zofenopril and ramipril and acetylsalicylic acid in postmyocardial infarction patients with left ventricular systolic dysfunction: a retrospective analysis in hypertensive patients of the SMILE-4 Study. J Hypertens. 2013;31(6):1256-64.
  12. Borghi C1, Bacchelli S, Degli Esposti D. Long-term clinical experience with zofenopril. Expert Rev Cardiovasc Ther. 2012;10(8):973-82

The fully formatted PDF version is available.    

  Download Article

Int J Biomed. 2015; 5(4):198-202. © 2015 International Medical Research and Development Corporation. All rights reserved.