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Orally active angiotensin-converting enzyme inhibitor (SO 14,225) as a treatment for essential hypertension
Insights
Captopril, an angiotensin-converting enzyme inhibitor, effectively lowers blood pressure in patients with essential hypertension. This treatment is well-tolerated and efficient, whether used alone or with diuretics.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Essential hypertension is a common condition requiring effective treatment.
- Angiotensin-converting enzyme (ACE) inhibitors represent a class of drugs targeting the renin-angiotensin-aldosterone system.
Purpose of the Study:
- To evaluate the efficacy and tolerability of captopril in patients with essential hypertension.
- To assess the impact of captopril on blood pressure and related hormonal markers.
Main Methods:
- Nine patients with essential hypertension received oral captopril.
- Blood pressure, plasma renin activity, angiotensin-converting enzyme activity, and plasma aldosterone levels were monitored.
Main Results:
- Captopril significantly reduced blood pressure (BP) in hospitalized patients.
- Concomitant increases in plasma renin activity and reductions in plasma-converting enzyme activity and aldosterone were observed.
- Chronic ambulatory therapy demonstrated sustained BP normalization, often requiring additional diuretic therapy.
Conclusions:
- Captopril is an effective and well-tolerated treatment for essential hypertension, irrespective of baseline plasma renin activity.
- Combination therapy with diuretics enhances captopril's efficacy.
- Captopril may offer superior blood pressure-lowering effects compared to beta-blockers.
Abstract:
1 Captopril (SQ14,225), an orally active inhibitor of angiotensin-converting enzyme, was administered to nine patients with essential hypertension. Plasma renin activity (PRA) was low in four, 'normal' in three and high in two patients. 2 In the hospital, captopril alone induced a significant drop in BP from 165 +/- 6/106 +/- 2 to 140 +/- 5/90 +/- 1 mmHb (P less than 0.001). PRA increased concomitantly (P less than 0.05), whereas plasma-converting enzyme activity (P less than 0.005) and plasma aldosterone (P less than 0.05) were reduced. 3 Six patients underwent chronic ambulatory therapy with captopril for a mean of 16 +/- 3 weeks. After discharge from the hospital, BP remained normalized but in five out of six patients this required additional diuretic therapy. 4 The results suggest that captopril alone or combined with diuretic therapy provides a new, efficient and well tolerated tool to treat patients with essential hypertension independently of their PRA level. It may turn out to be more effective in lowering BP than beta-adrenoceptor-blocking agents.