Enalapril in the treatment of hypertension with renal artery stenosis

G P Hodsman, J J Brown, A M Cumming, D L Davies, B W East, A F Lever, J J Morton, G D Murray, I Robertson, J I Robertson

Research output: Contribution to journalArticlepeer-review

Abstract

The converting enzyme inhibitor enalapril, in single daily doses of 10-40 mg, was given to 20 hypertensive patients with renal artery stenosis. The blood pressure fall six hours after the first dose of enalapril was significantly related to the pretreatment plasma concentrations of active renin and angiotensin II and to the concurrent fall in angiotensin II. Blood pressure fell further with continued treatment; the long term fall was not significantly related to pretreatment plasma renin or angiotensin II concentrations. At three months, 24 hours after the last dose of enalapril, blood pressure, plasma angiotensin II, and converting enzyme activity remained low and active renin and angiotensin I high; six hours after dosing, angiotensin II had, however, fallen further. The rise in active renin during long term treatment was proportionally greater than the rise in angiotensin I; this probably reflects the fall in renin substrate that occurs with converting enzyme inhibition. Enalapril alone caused reduction in exchangeable sodium, with distinct increases in serum potassium, creatinine, and urea. Enalapril was well tolerated and controlled hypertension effectively long term; only two of the 20 patients required concomitant diuretic treatment.

Original languageEnglish
Pages (from-to)1413-7
Number of pages5
JournalBritish medical journal (Clinical research ed.)
Volume287
Issue number6403
Publication statusPublished - 12 Nov 1983

Keywords

  • Adolescent
  • Adult
  • Angiotensin I
  • Angiotensin II
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Creatinine
  • Dipeptides
  • Enalapril
  • Female
  • Humans
  • Hypertension, Renovascular
  • Male
  • Middle Aged
  • Potassium
  • Renin
  • Sodium
  • Time Factors
  • Urea

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