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Captopril administered every three hours in difficult-to-control hypertension
S Vardan1, S Mookherjee, H Smulyan
1Department of Medicine, Veterans Administration Medical Center, State University of New York, Syracuse 13210-2799.
Chest
|July 1, 1992
Summary
Renovascular hypertension in an elderly patient initially responded to captopril. High-dose, frequent captopril was effective without side effects, avoiding other drug classes and maintaining control with lisinopril.
Area of Science:
- Nephrology
- Cardiology
- Geriatrics
Background:
- Renovascular hypertension (RVH) is a significant cause of secondary hypertension, particularly in the elderly.
- Standard treatment guidelines often recommend a stepwise approach for managing resistant cases.
Observation:
- An elderly patient with RVH initially controlled with standard captopril doses later required significantly higher and more frequent dosing (75 mg every 3 hours).
- This intensified regimen was well-tolerated, with no reported side effects.
Findings:
- The patient's refractory RVH responded effectively to high-dose, frequent captopril administration.
- Switching to alternative antihypertensive classes, a common strategy for recalcitrant hypertension, was successfully avoided.
Implications:
- Intensive angiotensin-converting enzyme inhibitor (ACEI) therapy may be a viable option for select elderly patients with refractory RVH.
- This approach can potentially prevent the need for multiple drug classes, simplifying management and reducing polypharmacy burden in geriatric populations.