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Long-term captopril therapy: evolving hemodynamic effects.

J M Sullivan, J C Taylor, D R Patrick

    Journal of Clinical Pharmacology
    |October 1, 1982
    PubMed
    Summary
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    Captopril initially lowers blood pressure and peripheral resistance in resistant hypertension patients. However, these effects may diminish over 12 months, even with additional therapies.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Hypertension Research

    Background:

    • Resistant hypertension poses a significant clinical challenge.
    • Captopril, an angiotensin-converting enzyme inhibitor, is used to manage hypertension.

    Purpose of the Study:

    • To evaluate the 12-month efficacy and hemodynamic effects of captopril in patients with resistant hypertension.

    Main Methods:

    • Nine patients with resistant hypertension received captopril for 12 months.
    • Blood pressure, total peripheral resistance, cardiac index, and forearm blood flow were monitored.
    • Plasma converting enzyme activity, renin activity, and aldosterone concentration were measured.

    Main Results:

    • Captopril initially reduced mean blood pressure and total peripheral resistance.

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  • These effects diminished by 12 months, with blood pressure and resistance returning to near-baseline levels.
  • Forearm blood flow showed a persistent increase, suggesting arteriolar effects.

    • Conclusions:

    • Captopril provides initial benefit in resistant hypertension but long-term efficacy may be limited.
    • Hemodynamic responses to captopril can wane over time, necessitating further therapeutic adjustments.
    • Individual patient responses vary, influenced by concomitant therapies and physiological factors.