Synergistic effect of captopril with hydrochlorothiazide for the treatment of low-renin hypertensive black patients.

Abstract

A common etiologic role for the renin-angiotensin system in essential hypertension was postulated 1 after a vasodepressor response was noted in 85% of patients with essential hypertension during converting enzyme inhibition. Curiously, however, captopril, a converting enzyme inhibitor that can be administered by mouth, occasionally causes a blood pressure fall in patients with low-renin hypertension (LRH), 2 3 suggesting that it has antihypertensive activity other than through blockade of angiotensin IIinduced vasoconstriction.Many patients with LRH exhibit enhanced aldosterone secretion in response to administered angiotensin II, 4 -5 as do patients with primary aldosteronism with bilateral zona glomerulosa hyperplasia, 6 ' 7 and have thus been postulated to have a mild form of primary

Plasma basic fibroblast growth factor is correlated with plasminogen activator inhibitor–1 concentration in adults from the Veterans Affairs Diabetes Trial

“…In a prior study in adults with microalbuminuric type 2 diabetes mellitus, treatment with ACE inhibitor drugs was associated with substantially lower levels of plasma bFGF bioactivity or immunoreactivity [9]. Because plasma renin activity varies considerably in humans [30], the present findings of substantially lower mean log plasma bFGF in African American subjects may be consistent (in part) with low renin hypertension common among African American patients [31]. Lower mean log bFGF for ARB use (Table 2) is consistent with a role for angiotensin II in the elaboration of increased plasma bFGF.…”

Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

“…4 Thus, the combination of ACE inhibitors with diuretics appears to represent an ideal choice in terms of efficacy, compliance, side effects and cost. [19][20][21] In fact, in our patients a near normalisation of BP values after diuretics administration was achieved. The synergistic action of ACE inhibitordiuretic combination allows the diuretic dose to be reduced, leading to a reduction in the metabolic side effects commonly observed with diuretic therapy.…”

Comparison of effects of captopril used either alone or in combination with a thiazide diuretic on insulin action in hypertensive Type 2 diabetic patients: a double‐blind crossover study

“…The hypotensive effect of diuretics is limited by stimulation of the renin–angiotensin–aldosterone axis[26], and the addition of an ACE inhibitor is a logical treatment combination[27]. Indeed the combination of an ACE inhibitor and a diuretic has been shown to be an effective blood pressure lowering combination[28, 29]. In the present study, the combination of bendrofluazide (2.5 mg) and captopril (100 mg) resulted in a significant reduction of blood pressure (16/6 mmHg) compared to captopril alone.…”