Effects of lisinopril on stress-induced peak blood pressure and sodium excretion: a double-blind controlled study.
A stress test was performed before (S1) and after a 1-month treatment period (S2) in patients with essential hypertension, randomly allocated to receive either an angiotensin-converting enzyme inhibitor (ACEI), lisinopril (n = 10), or placebo (n = 10). The two groups were similar with regard to systolic and diastolic blood pressure (SBP, DBP), body weight, renal function, and 24-h sodium excretion. At S1, stress induced a significant increase in SBP of 18 +/- 9 mm Hg and in DBP of 10 +/- 6 mm Hg and a significant reduction in sodium excretion from 258 +/- 105 to 204 +/- 72 mumol/min. Stress-induced sympathetic stimulation was assessed by a significant increase in urinary norepinephrine (NE) excretion from 21 +/- 10 to 26 +/- 10 micrograms/g creatinine. One-month treatment by placebo did not change stress-induced BP reactivity, sodium retention, or urinary NE excretion. In the lisinopril group, rest and stress BP were significantly reduced by the treatment. Stress-induced sodium retention was higher after 1-month placebo treatment (72 +/- 78 vs 48 +/- 67 mumol/min), whereas this retention was significantly reduced by lisinopril (13 +/- 27 vs 69 +/- 60 mumol/min).
Fauvel
J P
JP
Department of Nephrology and Hypertension, CNRS URA 1483, Hôpital Edouard Herriot, Lyon, France.
Laville
M
M
Bernard
N
N
Hadj-Aïssa
A
A
Daoud
S
S
Thibout
E
E
Pozet
N
N
Zech
P
P
D001794:Blood Pressure / Q000187:drug effects*; D003220:Conflict, Psychological; D003404:Creatinine / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D017706:Lisinopril / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000652:urine; D012146:Rest / Q000502:physiology; D012964:Sodium / Q000652:urine*; D013315:Stress, Psychological / Q000097:blood / Q000503:physiopathology* / Q000652:urine
D012964:Sodium; D003404:Creatinine; D017706:Lisinopril; D009638:Norepinephrine