Racial differences in renal vascular response to angiotensin blockade with captopril or candesartan.
OBJECTIVE
We compared the renal vascular response to captopril and candesartan among nondiabetic, normotensive black and white participants to explore angiotensin-converting enzyme-independent generation of angiotensin II.


METHODS
Thirteen black individuals and 10 white individuals in low-salt balance were given captopril and candesartan on sequential study days, and the renal plasma flow responses to these agents were measured.


RESULTS
Consistent with our prior observations, white individuals demonstrated a strong, significant correlation between responses to these drugs (r = 0.78, P = 0.008) and a significantly greater increase in the renal plasma flow in response to candesartan compared with captopril (104.2 +/- 26.8 versus 52.4 +/- 24.3 ml/min per 1.73 m; P = 0.03). In black participants, however, no correlation between responses to captopril and to candesartan was observed (r = 0.22, P = 0.47) and there was no difference in the renal plasma flow response between the two drugs (90.4 +/- 13.0 versus 80.4 +/- 15.3 ml/min per 1.73 m; P = 0.59). The difference in the response to the two drugs was significantly higher among white participants compared with black participants (P = 0.03).


CONCLUSIONS
We confirmed the contribution of an angiotensin-converting enzyme-independent pathway for angiotensin II generation in the kidneys of nondiabetic, normotensive white, but not black, individuals.
Forman
John P
JP
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. jforman@partners.org
Price
Deborah A
DA
Stevanovic
Radomir
R
Fisher
Naomi Dl
ND
D000328:Adult; D001741:Black or African American; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology; D001562:Benzimidazoles / Q000494:pharmacology*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001713:Biphenyl Compounds; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000494:pharmacology*; D004039:Diet, Sodium-Restricted; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000187:drug effects* / Q000378:metabolism; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D012016:Reference Values; D012079:Renal Circulation / Q000187:drug effects*; D017595:Renal Plasma Flow / Q000187:drug effects; D013777:Tetrazoles / Q000494:pharmacology*; D044465:White People
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D015415:Biomarkers; D001713:Biphenyl Compounds; D013777:Tetrazoles; D002216:Captopril; C081643:candesartan