Acute and chronic treatment of severe and malignant hypertension with the oral angiotensin-converting enzyme inhibitor captopril

Circulation
D B CaseJ H Laragh

Abstract

The patients with severe and 10 with accelerated or malignant hypertension were treated with the angiotensin-converting enzyme inhibitor captopril. Captopril acutely reduced blood pressure in all patients except two who had suppressed plasma renin activity. Four patients with encephalopathy showed immediate improvement after the first dose. Two patients could be withdrawn from nitroprusside infusion upon administration of captopril. Nineteen of 20 patients have remained on captopril for 12-32 months. Blood pressure is controlled in 18 and improved in two. Eleven required addition of diuretic and one addition of clonidine. The maximal antihypertensive effect of captopril with or without diuretics was evident after 3 months of continuous therapy and was associated with elevated plasma renin levels, normal aldosterone excretion and preservation of renal function. Captopril was well-tolerated, but produced occasional rash, loss of taste and proteinuria. We conclude that captopril, alone or in combination with other drugs, is effective in both the acute and long-term management of severe and malignant hypertension.

References

May 4, 1978·The New England Journal of Medicine·H GavrasD N McKinstry
Nov 3, 1979·British Medical Journal·G A MacGregorJ C Jones
Jan 1, 1979·Annals of Internal Medicine·C P TifftA V Chobanian
Jul 28, 1979·British Medical Journal·D H CoveD C Dukes
Nov 1, 1977·Annals of Internal Medicine·M A WeberJ H Laragh
Jun 30, 1975·JAMA : the Journal of the American Medical Association·C L Curry
Sep 20, 1973·The American Journal of Cardiology·P Kincaid-Smith
Jan 24, 1974·The New England Journal of Medicine·J Koch-Weser
Apr 1, 1973·Minerva cardioangiologica·B MagnaniM Sanguinetti
Dec 1, 1971·Acta Medica Scandinavica·L HanssonA Westerlund
Nov 1, 1968·Archives of Internal Medicine·H UedaY Kaneko
Jun 7, 1980·Lancet·S J HoorntjeP J Hoedemaeker
Jul 25, 1980·JAMA : the Journal of the American Medical Association·D B CaseJ H Laragh
Jul 1, 1980·Hypertension·H R BrunnerJ P Wauters
Jul 1, 1980·Hypertension·D W JohnsS C Williams
Jul 1, 1960·The Journal of Clinical Investigation·J H LARAGHS LIEBERMAN

❮ Previous
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Citations

Apr 1, 1986·Klinische Wochenschrift·P GremingerW Vetter
Jan 1, 1988·Journal of General Internal Medicine·J B Reuler, G J Magarian
May 1, 1985·Canadian Anaesthetists' Society Journal·E D Miller
Jan 1, 1986·American Heart Journal·R J Anderson, W G Reed
Jul 1, 1985·Biochemical Pharmacology·R E HowellC N Gillis
Jan 1, 1986·The Journal of Emergency Medicine·M S Catapano, J A Marx
Jan 1, 1992·Annals of Emergency Medicine·K Wrenn
Jun 1, 1994·Journal of Clinical Pharmacy and Therapeutics·D S McKindley, B A Boucher
Nov 19, 2003·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Masayuki TanemotoSadayoshi Ito
Apr 17, 1982·Lancet·J D SwalesH Thurston
Aug 7, 2003·Journal of Vascular and Interventional Radiology : JVIR·Mary Montrella Waybill, Peter N Waybill
Oct 1, 1984·The American Journal of Medicine·R K FergusonH H Rotmensch
Mar 1, 1991·The American Journal of Emergency Medicine·M Zell-Kanter, J B Leikin
Jan 1, 1989·Journal of Clinical Pharmacology·D M CummingsP H Vlasses
Nov 1, 1981·Clinics in Endocrinology and Metabolism·S A Atlas, D B Case
Jul 11, 2020·Journal of Hypertension·Philippe GosseAntoine Cremer
Jul 1, 1995·Current Problems in Surgery·G A SicardB T Allen

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