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Improved renal function during chronic lisinopril treatment in moderate to severe primary hypertension
A G Dupont1, P Van der Niepen, A Volckaert
1Department of Internal Medicine, University Hospital, Free University Brussels, Belgium.
Insights
Lisinopril effectively lowers blood pressure in hypertensive patients without impacting heart rate or cardiac output. This converting enzyme inhibitor also improves renal blood flow, indicating a favorable hemodynamic profile.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Primary hypertension poses significant risks to renal and cardiac health.
- Converting enzyme inhibitors are a key class of antihypertensive medications.
- Understanding the hemodynamic effects of these drugs is crucial for patient management.
Purpose of the Study:
- To evaluate the impact of lisinopril on renal and cardiac hemodynamics in patients with moderate to severe primary hypertension.
- To compare the antihypertensive efficacy and hemodynamic profile of lisinopril versus nifedipine.
Main Methods:
- A multicenter, double-blind, randomized clinical trial was conducted.
- 15 patients with primary hypertension were randomized to receive lisinopril (n=10) or nifedipine (n=5) after a placebo run-in period.
- Hemodynamic parameters, including blood pressure, heart rate, cardiac output, renal blood flow, and glomerular filtration rate, were assessed.
Main Results:
- Lisinopril significantly reduced blood pressure without altering heart rate or cardiac output.
- A significant increase in renal blood flow was observed with lisinopril.
- Glomerular filtration rate remained unchanged during lisinopril treatment.
Conclusions:
- Lisinopril is an effective antihypertensive agent for managing primary hypertension.
- Lisinopril demonstrates a favorable renal hemodynamic profile, enhancing renal blood flow.
- The findings support the use of lisinopril in hypertensive patients, particularly those where renal function is a concern.
Abstract:
The effect of the converting enzyme inhibitor lisinopril on renal and cardiac hemodynamics was studied in patients with moderate to severe primary hypertension, in a multicenter, double-blind, randomized clinical trial comparing the antihypertensive effect of lisinopril (LIS) and nifedipine (NIF). After a 2 week placebo run-in period, 15 patients were randomized in a 2:1 ratio to receive either LIS (20-80 mg q.d., n = 10) or NIF (20-40 mg b.i.d., n = 5). LIS significantly reduced blood pressure (BP) without changing heart rate or cardiac output. LIS significantly increased renal blood flow; glomerular filtration rate (GFR) was not changed. It can be concluded that LIS is an effective antihypertensive agent with a favorable renal hemodynamic profile.