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Converting enzyme inhibition in hypertensive emergencies
Annals of Internal Medicine
|January 1, 1979
Summary
Teprotide (SQ 20881) effectively lowered blood pressure in hypertensive emergencies, with responders showing a significant drop. This angiotensin converting enzyme inhibitor aids in choosing optimal therapy based on renin activity.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertensive emergencies require prompt diagnosis and effective treatment.
- The role of the renin-angiotensin system in hypertensive emergencies is crucial.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic utility of teprotide (SQ 20881) in hypertensive emergencies.
- To assess the correlation between baseline plasma renin activity and response to teprotide.
- To guide subsequent therapy based on teprotide's efficacy and patient response.
Main Methods:
- Administered intravenous teprotide (SQ 20881) at 1 mg/kg to 18 patients with hypertensive emergencies.
- Monitored blood pressure changes and categorized patients into responders and non-responders.
- Correlated baseline plasma renin activity with blood pressure response in untreated patients.
- Initiated tailored secondary therapies (propranolol, diuretics, combination) based on initial response.
Main Results:
- Responders (10 patients) experienced a mean blood pressure drop of 31 +/- 18 mm Hg.
- Non-responders (8 patients) showed a minimal blood pressure decrease of 5 +/- 3 mm Hg.
- A significant correlation (r=0.651, P<0.05) was found between log baseline plasma renin activity and blood pressure change in previously untreated patients.
- Tailored secondary therapies effectively reduced mean blood pressure from 152 +/- 47 to 102 +/- 31 mm Hg within 24 hours.
Conclusions:
- Teprotide (SQ 20881) serves as a valuable diagnostic tool in hypertensive emergencies.
- It facilitates the prompt selection of appropriate antihypertensive therapy based on the underlying renin-dependent mechanism.
- This approach allows for effective management of hypertensive emergencies by personalizing treatment strategies.
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