[Prospective evaluation of the captopril test in diagnosing renal artery stenosis in hypertensive patients].
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 Antihypertensive drugs were withdrawn one week before the CT or, if this was considered unsafe, patients were treated with nifedipine or diltiazem (53 subjects; 56.4%).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.
Secchi
M B
MB
Divisione di Medicina Interna, Ospedale Bassini, Cinisello Balsamo, Milano.
Mancarella
S
S
Wu
S C
SC
Bettazzi
L
L
Pietra
M
M
Loche
G
G
Merlo
E M
EM
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
D002216:Captopril
Valutazione prospettica del test al captopril nella diagnosi di stenosi di arteria renale in soggetti ipertesi.