SUMMARY The role of plasma angiotensin II (Ang II) in furosemide-stimulated renal prostaglandin Ej (PGEj) production was evaluated in eight healthy subjects. Urine was collected for 60 minutes after forosemide administration (20 mg i.v.) with or without captopril pretreatment, and urinary excretion of PGE 2 , sodium, and furosemide was determined. Plasma renin activity (PRA) and Ang II were also measured before and 60 minutes after furosemide administration. Urinary PGEj excretion, PRA, and Ang II increased after furosemide administration without captopril pretreatment, and there was a significant correlation between the increment in Ang II and that in urinary PGE 2 excretion. Urinary PGE 2 excretion and Ang II did not increase after furosemide administration with captopril pretreatment. Urine volume and urinary excretion of sodium and furosemide were not influenced by captopril pretreatment. These results suggest that Ang II may play an important role in furosemide-stimulated PGE 2 production. (Hypertension 11: 491-494, 1988) KEY WORDS • furosemide • prostaglandin E 2 • angiotensin II F UROSEMIDE, a potent loop diuretic, is a widely used therapeutic agent for treatment of hypertension and congestive heart failure. Some effects of furosemide are reported to be partly dependent on renal prostaglandin E2 (PGE2) produced by furosemide administration. 12 This elevation in renal PGEj production, as reflected by urinary PGEj excretion, 3 following furosemide administration could be mediated directly by inhibition of renal 15-hydroxyprostaglandin dehydrogenase 4 and 9-ketoreductase 5 activities. Since furosemide activates the renin-angiotensin system, the elevated levels of angiotensin II (Ang II) may in turn stimulate synthesis of renal PG1V To determine whether the indirect action of Ang II plays an important role in furosemide-induced renal PGE2 production, we investigated urinary PGE2 excretion after furosemide administration with or without pretreatment with captopril, an oral converting enzyme inhibitor, in healthy subjects.
Subjects and Methods
ProtocolEight healthy male subjects, 22 to 28 years old, gave informed consent to the protocol and were studied on From the Department of Clinical Pharmacology, Oita Medical School, Oita, Japan.Address for reprints: Akio Fujimura, M.D., Department of Clinical Pharmacology, Oita Medical School, Hazama, Oita-gun, Oita 879-56, Japan.Received October 5, 1987; accepted January 5, 1988. three separate occasions. The subjects were requested to refrain from sexual activity and not to take nonsteroidal anti-inflammatory drugs for at least 48 hours before the study. Sodium intake was not restricted until the night before the study. Urine was collected for 24 hours on the day before each study. After fasting overnight, subjects were given 400 ml of water to drink at 0900, 1030, 1200, and 1300 and were asked to void at 1300. The subjects remained supine throughout the study except for 1 to 2 minutes of standing to pass urine. In the first study, urine was collected for 60 minut...