title: Participation of the renin system in treatment-resistant hypertension as measured by acute blockade of the angiotensin converting enzyme.
abstract: The acute blood pressure response to the angiotensin converting enzyme inhibitor, captopril, was used to measure participation of the renin-angiotensin system in treatment-resistant hypertension. By 2 h after a single 25-mg oral captopril dose in patients still receiving a diuretic-vasodilator-beta-blocker combination, systolic and diastolic blood pressures had fallen significantly; the decrease in diastolic pressure correlated with the control (immediately pre-captopril) plasma renin activity (r = 0.64, p less than 0.001). Apart from its possible contribution to the underlying hypertension, this captopril-identified renin component may have reflected diuretic and vasodilator-induced renin stimulation that could not adequately be prevented by the renin-lowering properties of the beta-blocker. Captopril, and perhaps other specific antirenin drugs, therefore, may be valuable adjuncts to treatment in patients with hypertension refractory to conventional therapy.
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D006977:Hypertension, Renal / Q000188:drug therapy*; D006978:Hypertension, Renovascular / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011392:Proline / Q000031:analogs & derivatives*; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000450:Aldosterone; D011392:Proline; D002216:Captopril; D012083:Renin