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Captopril in Cushing's syndrome.

P Greminger, W Vetter, H Groth

    Klinische Wochenschrift
    |September 17, 1984
    PubMed
    Summary

    The renin-angiotensin system significantly impacts hypertension in Cushing's syndrome, particularly when plasma renin activity is high. Captopril

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    Area of Science:

    • Endocrinology
    • Cardiovascular Medicine
    • Hypertension Research

    Background:

    • Cushing's syndrome is characterized by hypercorticism, often leading to hypertension.
    • The role of the renin-angiotensin system (RAS) in Cushing's syndrome-related hypertension requires further elucidation.
    • Understanding the mechanisms of hypertension in Cushing's syndrome is crucial for effective management.

    Purpose of the Study:

    • To investigate the involvement of the renin-angiotensin system in the development of hypertension in patients with Cushing's syndrome.
    • To assess the effect of captopril, an angiotensin-converting enzyme inhibitor, on blood pressure in Cushing's syndrome patients with varying plasma renin activity (PRA).
    • To compare the RAS-mediated blood pressure response in Cushing's syndrome with that in essential hypertension.

    Main Methods:

    • Ten patients with Cushing's syndrome received a single oral dose of 25 mg captopril.
    • Mean arterial pressure (MAP) was monitored for up to 240 minutes post-administration.
    • Plasma renin activity (PRA) was measured before captopril administration; eleven essential hypertension patients served as controls.

    Main Results:

    • Patients with elevated basal PRA (> 3 ng/ml X 3 h) in both Cushing's syndrome and essential hypertension groups showed a significant MAP reduction after captopril.
    • The blood pressure decrease was slightly more pronounced in essential hypertensives with high PRA.
    • Patients with normal PRA (≤ 3 ng/ml X 3 h) exhibited minimal MAP changes, with statistical significance only reached later in the observation period for both groups.

    Conclusions:

    • In Cushing's syndrome, the blood pressure-lowering effect of captopril is dependent on the activity of the renin-angiotensin system.
    • The RAS plays a significant role in the pathogenesis of hypertension in a substantial number of hypercorticism patients.
    • In patients with low PRA, other factors, such as mineralocorticoid over-secretion, likely contribute to elevated blood pressure in Cushing's syndrome.

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