Effects of the new oral angiotensin converting enzyme inhibitor 2-[N-[(S)-1-ethoxycarbonyl-3-phenylpropyl]-L-alanyl]-(1S,3S,5S)-2- azabicyclo[3.3.0]octane-3-carboxylic acid (Hoe 498) in essential hypertension.

In a dose titration study patients with mild to moderate essential hypertension were treated with increasing doses of 2-[N-[(S)-1-ethoxycarbonyl-3-phenylpropyl]-L-alanyl]-(1S,3S, 5S)-2-azabicyclo[3.3.0]octane-3-carboxylic acid (Hoe 498) (up to 8 mg daily) for 3 weeks. Hoe 498 was tolerated well. 9 out of 20 patients responded to 1 mg b.i.d., the blood pressure in a further 5 patients normalized with 2 mg b.i.d. Six patients did not respond to Hoe 498 treatment (4 mg b.i.d. in the last week) according to the criterion: recumbent diastolic blood pressure less than or equal to 90 mm Hg. But all 6 patients showed a clear decrease in blood pressure during treatment.