Plasma renin activity levels influence the effect of converting enzyme inhibitors in preserving renal function in hypertension.
OBJECTIVE
To study the effect of treatment with cilazapril versus nifedipine on the glomerular filtration rate (GFR), microalbumin excretion rate (mu Alb) and baseline plasma renin activity (PRA) levels in non-diabetic or diabetic essential hypertension.


METHODS
Thirty-four moderate essential hypertensives and thirty-two type II diabetic hypertensives with currently normal renal function completed the study, receiving treatment with a converting enzyme inhibitor (CEI, 5-10 mg/day cilazapril) or a non-CEI (20-40 mg slow-release nifedipine three times a day) during a 12-month controlled follow-up study.


RESULTS
Either treatment induced a similar reduction in blood pressure. Patients with PRA > 3 ng/ml per h treated with cilazapril showed a proportional increase in GFR, whereas in those treated with a non-CEI there was a decline in GFR after 8 and 12 months. Only diabetic patients treated with cilazapril showed a mu Alb reduction associated with a stable GFR.


CONCLUSIONS
PRA predicts the effect of CEI preserving renal function in essential and diabetic hypertension.
Sanchez
R A
RA
Division of Hypertension, Hospital Instituto de Cardiologia-Academia Nacional de Medicina, Buenos Aires, Argentina.
Migliorini
M
M
Giannone
C
C
Ramirez
A J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*
D000806:Angiotensin-Converting Enzyme Inhibitors; D012083:Renin