Long term effect of captopril in hypertension with chronic renal failure

We report the use of the orally active converting enzyme inhibitor Captopril in hypertensive patients with mild chronic renal failure. Twenty eight patients were followed for a period of six months. Eleven patients required the addition of furosemide. Mean arterial pressure (MAP) decreased in all but two at six months (MAP: 102 +/- 0.8 vs 133 +/- 2.2mmHg, p less than 0.001). Untoward effects were frequent: the commonest reactions are loss of taste (four patients), skin rashes (11 patients), proteinuria (2 patients), tachycardia (2 cases). These side effects disappeared after reduction of dose (10 cases) or withdrawal (8 cases). Patients on 300mg daily or less were free of any untoward effect. In summary (i) Captopril alone or in combination with furosemide has an antihypertensive effect in patients with chronic renal failure and hypertension; (ii) side effects seem to be dose dependant and a reduced dosage should be used in these patients.