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Prolonged converting enzyme inhibition in non-modulating hypertension
1Endocrine-Hypertension Unit, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Hypertension (Dallas, Tex. : 1979)
|April 1, 1989
Summary
Longer converting enzyme inhibition (CEI) duration fully restored aldosterone response to angiotensin II (Ang II) in non-modulating hypertension patients. This suggests prolonged CEI corrects adrenal sensitivity defects in essential hypertension.
Area of Science:
- Endocrinology
- Hypertension Research
- Renal Physiology
Background:
- Essential hypertension is characterized by impaired adrenal response to angiotensin II (Ang II) in non-modulating patients.
- Previous studies showed partial correction of this defect with short-term converting enzyme inhibition (CEI).
Purpose of the Study:
- To determine if prolonged CEI can fully restore adrenal responsiveness to Ang II in non-modulating hypertension.
- To differentiate between persistent abnormality and insufficient CEI duration.
Main Methods:
- 13 patients with normal- or high-renin hypertension were studied.
- Ang II infusion assessed adrenal and renovascular responses on a low sodium diet.
- Enalapril (CEI) administered for 72 hours and 6 weeks, with repeated Ang II dose-response assessments.
Main Results:
- Modulating patients showed no change in aldosterone response after CEI.
- Non-modulating patients showed partial restoration after 72 hours of CEI.
- Prolonged CEI (6 weeks) completely corrected the aldosterone response defect in non-modulators.
Conclusions:
- Short-term CEI partially corrects, but prolonged CEI (6 weeks) fully restores, aldosterone responsiveness in non-modulating hypertension.
- This suggests that the duration of CEI is critical for normalizing adrenal sensitivity to Ang II in this patient group.