Wir verwenden standardmäßig essenzielle Cookies (Anmeldung, deine gespeicherten Ziele/Stacks). Mit deiner Erlaubnis aktivieren wir außerdem datenschutzfreundliche Analytik (Vercel Web Analytics, anonyme Ladezeit-Metriken) und Fehler-Replay-Diagnostik (Sentry — DOM-Snapshots nur, wenn ein Fehler auftritt), damit wir Bugs schneller beheben können. Mehr über Cookies erfahren
Cpt3.5
Captopril – Forschung
Überwiegend Mechanismus / Beobachtung
30 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Captopril sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen randomisierten Studien, veröffentlicht 2003–2026 mit einer typischen Studiengröße von 88 Teilnehmenden.
Basierend auf 30 Studien · 7 RCTs · 10,543 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Cardiovascular & renalReduziert Mortalität und Morbidität bei Herzinsuffizienz und nach Myokardinfarkt (Humane RCTs) · Monate bis Jahre
Überwiegend Mechanismus / Beobachtung21 Studien
Lifespan & aging (model organisms)
Überwiegend Mechanismus / Beobachtung6 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung3 Studien
Aktives Forschungsgebiet
28 Studien in den letzten 5 Jahren
200320142026
1RCTn=242 · medium study2026
Conclusions In adults with type 1 diabetes and CKD, finerenone resulted in a significantly greater decrease in the urinary albumin-to-creatinine ratio than placebo. (Funded by Bayer; FINE-ONE ClinicalTrials.gov number, NCT05901831.).
Heerspink HJL, Birkenfeld AL, Cherney DZI, Colhoun HM, Groop PH, Ji L, Jongs N, Mathieu C, Pratley RE, Rosas SE, Rossing P, Skyler JS, Tuttle KR, Lawatscheck R, Brinker M, Scheerer MF, Russell J, Schloemer P, McGill JB, FINE-ONE Investigators. · The New England journal of medicine (2026)
The most common adverse event was hyperkalemia (in 12 participants [10.1%] with finerenone and in 4 [3.3%] with placebo); 2 participants (1.7%) discontinued finerenone because of hyperkalemia.
At 6 months, the change in the eGFR was -5.6 ml per minute per 1.73 m 2 with finerenone and -2.7 ml per minute per 1.73 m 2 with placebo (difference, -2.9 ml per minute per 1.73 m 2 ; 95% CI, -5.1 to -0.7); eGFR values approached baseline levels during the washout period.
Conclusions In adults with type 1 diabetes and CKD, finerenone resulted in a significantly greater decrease in the urinary albumin-to-creatinine ratio than placebo. (Funded by Bayer; FINE-ONE ClinicalTrials.gov number, NCT05901831.).
Interventions targeting clinician awareness, postdischarge support and institutional practice variation may improve adherence to guideline-recommended therapy.
Senanayake S, Lee ASY, Graves N, Win PPS, Lee A, Lau YH, Hausenloy DJ, Yeo KK, Chan MY, Wong RCC, Loh SY, Sim KLD, Chow W, Tan KB, Kularatna S. · BMJ open (2026)
Participants 3999 adults hospitalised from 2020 to 2022 with a first heart failure-related admission and left ventricular ejection fraction ≤40%.
Results Among eligible patients, 80%-99% met criteria for each GDMT drug class, yet only 29% received quadruple therapy at discharge in 2022.
Prescription rates for ACEi/ARB/ARNI (67%), beta-blockers (89%), MRAs (40%), and SGLT2 inhibitors (46%) remained suboptimal despite high eligibility.
Directions for future research are defined to determine the molecular targets of captopril further and to optimize its clinical utility in the management of cardiovascular and possibly other diseases.
Stoiljkovic M, Jakovljevic V, Milosavljevic J, Bolevich S, Jeremic N, Canovic P, Fisenko VP, Tikhonov DA, Krylova IN, Bolevich S, Chichkova NV, Zivkovic V. · International journal of molecular sciences (2025)
Captopril, a well-established angiotensin-converting enzyme (ACE) inhibitor, has garnered attention for its cardioprotective effects in preventing heart remodeling and maintaining cardiac function, significantly improving life quality.
Although it appeared to be overlooked in clinical practice, in recent years, additional efforts have been made to uncover the mechanisms of all drug effects, as recent research studies predict a wide spectrum of diseases beyond the recommended indications.
This review thoroughly examines the mechanisms by which captopril mediates its protective effects, bridging basic biochemical observations with applied clinical investigation, especially during ischemic reperfusion (I/R) injury, hypertension, and heart failure (HF).
Geng Y, Guan C, Jiang Y, Yang W, Yu B, Fu G, Pu J, Qu X, Zhang Q, Zhao Y, Yu L, Huang Y, Tu S, Qiao S, Song L. · Heart (British Cardiac Society) (2026)
Results Among 3221 (85.2%) patients who achieved FCR, a total of 1964 (61.2%), 1919 (59.9%), 1545 (48.4%), 1483 (46.6%) and 1084 (35.3%) patients adhered to GDMT at 1 month, 6 months, 1 year, 2 years and 3 years, respectively.
The MACCE occurred in 313 (10.2%) patients through 3 years.
Conclusions In patients who achieved FCR, the benefit of good adherence to GDMT remained significant, starting from the second year and continuing up to 3 years.
Pepine CJ, Handberg E, Cooper-DeHoff R, Cook-Wiens G, Diniz MA, Frayne S, Lo MC, Smith SM, Harris B, Wei J, Chaitman BR, Spertus JA, Berry C, Weintraub W, Bairey Merz CN. · Open heart (2026)
At 2.5 years, 421 events occurred (221 in IMT, 200 in UC) with no difference in the primary outcome (HR=1.13 (95% CI 0.94 to 1.37) for IMT vs UC, p=0.20) or secondary outcomes.
Sensitivity analysis of contamination provided an estimated HR for IMT versus UC of 0.74 95% CI (0.352 to 1.558), p=0.43.
Conclusions and relevance Among women with suspected ANOCA/INOCA, outcomes were dominated by chest pain and IMT did not improve outcomes, although limited power precludes concluding that it may not be helpful.
Clinicians are therefore advised to consider zinc status and provide supplementation when deficiency is suspected.
Bahadoran Z, Hosseinpanah F. · Biological trace element research (2026)
Angiotensin converting enzymes inhibitors (ACEIs), particularly captopril (CPT), reduce SZn by 5-13% and increase urinary zinc excretion 1.4- to 3.8-fold, with combinations with diuretics amplifying renal zinc loss up to 10.6-fold.
Diuretics alone increase UZn loss by 1.6- to 3.7-fold, with minor or variable effects on SZn.
Overall, ACEIs and diuretics have the most significant impact on zinc metabolism, primarily through enhanced renal excretion, while other medications had mild effects.
This hybrid approach provides a greater opportunity to improve drug therapy for cardiovascular disease and viral infections, and represents the rewards of collaboration.
Fahim AM. · Computational biology and chemistry (2026)
Through the combinatorial application of computational drug design and experimental chemistry, researchers have significantly optimized the drug discovery process, minimized off-target effects, and expedited the pathway to develop therapeutically useful medications.
In conclusion, this review highlights the transformative power of interdisciplinary approaches, including structure-based design, computational modeling, and the emerging approaches of drug repurposing and virtual screening.
This hybrid approach provides a greater opportunity to improve drug therapy for cardiovascular disease and viral infections, and represents the rewards of collaboration.
Randomized controlled trials have been initiated to evaluate the treatment effects of beta-blocker and antiplatelet therapy in SCAD patients.
Kalkman DN, Vink AS, Beijk MAM, van den Born BH, Ten Berg JM, Arslan F, Appelman Y, Wierda E. · Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation (2025)
Spontaneous coronary artery dissection (SCAD) occurs in 1-4% of acute coronary syndromes (ACS).
In SCAD, an intramural hematoma compresses the true lumen of the coronary artery, leading to ischemia and, even acute myocardial infarction.Approximately, 90% percent of SCAD patients are premenopausal women without classical risk factors for atherosclerosis.
Despite medical treatment, 10-20% of SCAD patients experience a recurrence within 4 years.
Daum N, Bill D, Thiele M, Felber J, von Wedel D, Spies C, Balzer F, Mörgeli R, Hunsicker O, Müller A, Contag D, Pohrt A, Bald A, Kayser M, Treskatsch S, Markus M. · Frontiers in cardiovascular medicine (2025)
Older age (OR 1.03, 95% CI 1.02-1.04) and female sex (OR 1.16, 95% CI 1.08-1.24) were associated with increased IOH risk.
ASA-II was linked to lower risk compared to ASA-III (OR 0.80, 95% CI 0.70-0.91).
Diabetes mellitus (OR 1.18, 95% CI 1.04-1.35) and arterial hypertension (OR 1.56, 95% CI 1.33-1.83) were independent predictors.
The trials had a median of 276 participants (105-464), a mean left ventricular ejection fraction of 28%, and a median follow-up time of 5 months (3-8).
Individually, the most effective treatments for improving quality of life were SGLT2i (MD, +3.4 [+1.4 to +5.30]), ivabradine (MD, +3.3 [+0.1 to +6.4]), ARNi (MD, +2.6 [-3.2 to +8.5]), and MRA (MD, +1.8 [-4.8 to +8.4]).
Interventions to improve adherence among patients with HF are needed.
Murray-Thomas T, Bottle A, Mayet J, Myles P. · Open heart (2025)
Non-adherence was based on proportion of days covered (PDC) and defined as PDC<80%.
Results About 43.6% of patients were non-adherent to therapy.
In the analysis treating PDC as a continuous variable, every 10% decrease in PDC levels was associated with a 6% increased hazard of all-cause mortality (HR 1.06, 95% CI 1.05 to 1.06) and was significantly associated with CVD, but not HF mortality.
For all these reasons, it was essential to re-consider the pharmacological therapy of patients with HFrEF in this iteration of the NICE guidelines.
· Unknown Journal (2025)
Chronic heart failure (CHF) with reduced ejection fraction (HFrEF) is defined by both the heart failure syndrome and a left ventricular ejection fraction <40%.
The step-wise approach hitherto adopted not infrequently leads to patients being on maximal doses of two or may be three agents and unable to tolerate the third agent, and certainly not able to tolerate the fourth.
Therefore, using this pathway may have resulted in suboptimal treatment.
13RCT2026
While quinapril showed numerically greater improvements in FMD, this did not reach statistical significance, highlighting heterogeneity across vascular beds and warranting caution in interpreting surrogate markers.
Yilmaz Y, Celik FB, Atici A, Guvenc TS, Gullu H, Caliskan AE, Kahyaoglu M, Celik M, Caliskan M. · Journal of hypertension (2026)
Both treatments effectively lowered blood pressure and improved FMD and CFR from baseline ( P < 0.05).
Improvements in CFR were comparable between treatments.
Conclusion In patients with newly diagnosed hypertension, both lipophilic and hydrophilic ACE inhibitors improve peripheral endothelial and coronary microvascular function.
Conclusions It was found that cold application to the back of the neck reduced blood pressure in patients with hypertension.
Uren Y, Kiyak E, Karadas S. · Applied nursing research : ANR (2026)
Results There was a significant decrease in systolic blood pressure in the experimental group during the first 27 min following cold application compared to the placebo and control group (p < 0.05).
Further, there was a significant decrease in diastolic blood pressure during the first 17 min following cold application in the experimental group compared to the placebo and control group (p < 0.05).
Furthermore, a significant decrease in headache severity was observed in the experimental group compared to the control group during 12 min after application.
The need for a second dose in the captopril group and the placebo group was 12.3 and 75.4%, respectively.Conclusion The study confirmed the efficacy and safety of captopril compared to placebo in patients with a marked increase in BP in the absence of damage to target organs, which supports the validity of using captopril as a first-line drug in such clinical situations.
Gilyarevsky SR, Kulibaba EV, Pobedinskaya TA, Rodyukova IS, Manko KS, Timoshina EV. · Kardiologiia (2025)
At one hour after study drug dosing in the captopril group and the placebo group, mean decrease in SBP was 22.0 ± 10.7 and 11.8 ± 11.9 mm Hg, respectively (p < 0.001).
At one hour after captopril dosing, the mean decrease in DBP was 14.1±8.3 and 7.5±5.8 mm Hg, respectively (p<0.001).
At baseline, systolic BP (SBP) and diastolic BP (DBP) before the administration of the study drug did not differ significantly between the groups.
For those with HAE, short- and long-term prophylaxis and on-demand therapy must be considered.
Young MC, Banerji A. · Allergy and asthma proceedings (2025)
Bradykinin-mediated angioedema presents without urticaria, whereas histaminergic angioedema is usually associated with urticaria (i.e., chronic spontaneous urticaria and angioedema) but manifests with isolated angioedema in ∼20% of patients and clinically overlaps with idiopathic angioedema.
Idiopathic angioedema is the largest category and is diagnosed when patients experience angioedema without an identifiable etiology with nl-C1INH function and no family history of angioedema.
Idiopathic angioedema is further characterized into histaminergic or nonhistaminergic angioedema, depending on the response to high-dose antihistamines.
Small numbers, absence of a control group, insensitivity of echo-ejection fraction, and additional drug use probably prevented divergence between groups.
Bourke JP, Bryant A, Landon G, Burn A, Spinty S, Quinlivan R, Alhaswani Z, Chadwick T, Muntoni F, Guglieri M, DMD Heart Study Group. · European journal of neurology (2025)
Absolute LVEF% values reduced in both groups ('active': 62.5% ± 5.6% to 53.8% ± 4.0%; 'placebo': 60.6% ± 4.9% to 50.4% ± 8.5%).
Despite trends favoring earlier introduction of therapy, change from baseline was similar between groups (adjusted mean difference: -7.7 (95% CI -16.4 to1.0%)).
However, more in the 'placebo' arm had died, had reduced LVEF%, and were taking additional heart medications.
Conclusion Continuation of antihypertensive treatment with methyldopa in the postpartum period yielded similar results to switching it for captopril, both with regard to the efficacy in controlling blood pressure and the safety of the treatment.
Main outcome measures Logistic regression was used to compare the groups regarding the potential to maintain blood pressure below 140/90 mmHg at over 50 % of measurements postpartum.
Following delivery, the patients were randomized either to continue with methyldopa at a minimum dose of 250 mg, three times a day (methyldopa group, n = 88) or to switch to captopril at an initial dose of 25 mg, three times a day (captopril group, n = 84).
Conclusion Continuation of antihypertensive treatment with methyldopa in the postpartum period yielded similar results to switching it for captopril, both with regard to the efficacy in controlling blood pressure and the safety of the treatment.
The combination of an ACE inhibitor, biguanide and moxonidine may in some cases be a preferred pharmacotherapy option for patients with AH and early carbohydrate metabolism disorders due to the observed significant metabolic benefits.
Skibitsky VV, Gutova SR, Fendrikova AV. · Kardiologiia (2025)
In a comparable number of patients in both groups, the treatment was associated with normalization of the LV myocardial geometry and diastolic function.
The combination of an ACE inhibitor, biguanide and moxonidine may in some cases be a preferred pharmacotherapy option for patients with AH and early carbohydrate metabolism disorders due to the observed significant metabolic benefits.
Results Three months post-treatment and relative to the control group, the carvedilol group exhibited significantly reduced serum levels of MDA (P2 = 0.003), 4-HNE (P2 < 0.001), and GAS-17 (P2 = 0.015), which was associated with significantly higher serum levels of PGE2 (P2 < 0.001).
Additionally, the carvedilol group showed a significantly higher SAQ-7 score (P2 = 0.033) and a significantly lower SAGIS questionnaire score (P2 = 0.04) than the control group.
Conclusion Carvedilol could represent a potential gastroprotective agent for patients with IHD on aspirin therapy secondary to its efficacy and safety.