title: [Prospective evaluation of the captopril test in diagnosing renal artery stenosis in hypertensive patients].
abstract: In order to verify the utility of the captopril test (CT) in diagnosing renal artery stenosis we performed a prospective study in 94 consecutive patients (40 females, 54 males, mean age 52.4 +/- 12.3 years) suspected of having renovascular hypertension and with a serum level of creatinine < 2 mg/dl. Antihypertensive drugs were withdrawn one week before the CT or, if this was considered unsafe, patients were treated with nifedipine or diltiazem (53 subjects; 56.4%). We used renal angiography and the Muller criteria to interpret the CT. Our results were as follows: sensitivity, 92%; specificity, 96%; positive predictive value, 88%; and negative predictive value, 97%. In our study a simplified criterion for positive CT-postcaptopril plasma renin activity > 10 ng/mL/h-provided a similar diagnostic value. We conclude that the captopril test is a useful screening test for the detection of renal artery stenosis in selected hypertensive patients and that it can also be reliably performed in patients who are taking calcium antagonists.
authors.affiliation: Divisione di Medicina Interna, Ospedale Bassini, Cinisello Balsamo, Milano.
authors.forename: M B
authors.initials: MB
authors.lastname: Secchi
authors.forename: S
authors.initials: S
authors.lastname: Mancarella
authors.forename: S C
authors.initials: SC
authors.lastname: Wu
authors.forename: L
authors.initials: L
authors.lastname: Bettazzi
authors.forename: M
authors.initials: M
authors.lastname: Pietra
authors.forename: G
authors.initials: G
authors.lastname: Loche
authors.forename: E M
authors.initials: EM
authors.lastname: Merlo
mesh_terms: D000328:Adult; D000368:Aged; D002216:Captopril; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D002216:Captopril
vernacular_title: Valutazione prospettica del test al captopril nella diagnosi di stenosi di arteria renale in soggetti ipertesi.