Captopril in treatment-resistant essential and renal hypertension.
Captopril, an angiotensin converting enzyme inhibitor, was used to treat 25 patients with treatment-resistant hypertension of long duration. Seven patients had essential hypertension, 10 renovascular hypertension and 8 renoparenchymatous hypertension. All patients had GFR greater than 25 ml/min/1.73 m3 BSA. The acute blood-pressure-lowering response to the drug was shown to be dependent on the prevailing activity in the renin-angiotensin system. Its long-term effect was not correlated to the activation of the renin-angiotensin system as the mean blood-pressure decrease was not significantly different for high renin and normal renin patients (21 +/- 3% vs. 19 +/- 2%). All patients needed addition of diuretics and betablockers for optimum control. Nine patients have been well controlled for one year and several of them are now approaching two years' treatment. A few adverse effects were observed, including taste disturbances and increased proteinuria. The latter side effect occurred in two patients with decreased renal function and pre-existing proteinuria. Upon reduction of the dose the proteinuria returned to pre-treatment levels within a few months. We conclude that altogether 78% of these patients with treatment-resistant hypertension obtained greatly improved long-term blood-pressure control on treatment including captopril.
D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D006977:Hypertension, Renal / Q000188:drug therapy*; D006978:Hypertension, Renovascular / Q000188:drug therapy*; D011392:Proline / Q000031:analogs & derivatives*; D011507:Proteinuria / Q000139:chemically induced
D011392:Proline; D002216:Captopril