Hemodynamic and renal function in essential hypertension during treatment with enalapril.
Enalapril (at a mean dose of 25 mg), a potent, long-acting angiotensin converting enzyme inhibitor, was prescribed in combination with hydrochlorothiazide (at a mean dose of 64 mg) for 96 weeks in 11 patients with essential hypertension who had pretreatment (placebo) glomerular filtration rates of less than 80 ml/minute/1.73 m2. Blood pressure was well controlled. After 56 weeks of therapy, glomerular filtration rate (assessed by inulin clearance) increased 55 percent and effective renal plasma flow (assessed by para-amino-hippurate clearance) increased by 32 percent; these increases were sustained through the 96 weeks of therapy. Furthermore, gains in renal function were sustained without adversely affecting 24-hour urinary protein excretion, sodium excretion, or body fluid composition. These results suggest that enalapril, in combination with hydrochlorothiazide, has the pharmacologic capability to favorably modify a primary pathophysiologic characteristic of essential hypertension by decreasing renal vascular and mesangial tone.
D000328:Adult; D000368:Aged; D001826:Body Fluids / Q000187:drug effects; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D008875:Middle Aged
D006852:Hydrochlorothiazide; D004656:Enalapril