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ACE inhibitors: antihypertensive treatment and renal function
L Campanacci1, G Bellini, A Cosenzi
1Institute of Medical Pathology, University of Trieste, Italy.
Drugs Under Experimental and Clinical Research
|January 1, 1989
Summary
Angiotensin-converting enzyme inhibitors (ACE-I) are safe for treating hypertension in patients with normal kidney function. However, these drugs may impair renal function in individuals with renovascular hypertension.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Pharmacology
Background:
- Essential hypertension impacts kidney function.
- Some antihypertensive drugs negatively affect renal hemodynamics.
- Angiotensin-converting enzyme inhibitors (ACE-I) are first-line hypertension treatments.
Purpose of the Study:
- To review the acute and chronic effects of ACE-I on renal function.
- To assess the safety and efficacy of ACE-I in hypertensive patients.
Main Methods:
- Literature review of clinical evidence on ACE-I and renal function.
- Analysis of studies examining ACE-I effects on glomerular filtration rate (GFR), renal plasma flow (RPF), and blood pressure.
Main Results:
- In hypertensive patients with normal renal function, ACE-I administration led to decreased blood pressure with stable or increased GFR and RPF.
- Renal vascular resistance decreased following ACE-I treatment.
- Renal function deteriorated in patients with renovascular hypertension (bilateral stenosis or solitary kidney).
Conclusions:
- ACE-I are safe and effective for essential hypertension management in patients with normal renal function.
- ACE-I demonstrate protective effects on renal hemodynamics in this population.
- Caution is advised when using ACE-I in patients with specific forms of renovascular hypertension due to potential renal function decline.