Converting enzyme inhibitors in the treatment of hypertension

Journal of Cardiovascular Pharmacology
J I Robertson, D M Tillman

Abstract

The renin-angiotensin system has a wide range of physiological actions, and thus interference with the system has attractive therapeutic potential. The orally active angiotensin converting enzyme (ACE) inhibitors have so far been the most successful drugs in this area. They lower arterial pressure both in renovascular and essential hypertension, and their effects are enhanced by concomitant diuretic therapy or dietary salt restriction. Since, in renovascular hypertension, the affected kidney depends on enhanced local generation of angiotensin II to help preserve its function, the circulation and excretory capacity of this kidney may be compromised with ACE inhibition. ACE inhibitors can improve exercise tolerance and diminish cardiac ventricular arrhythmias in patients with heart failure. Because these drugs lower plasma aldosterone, they tend to correct potassium deficiency and hypokalemia, which may have been induced by diuretic treatment. Hypotension can occur with the first dose of ACE inhibitor, especially in sodium-depleted subjects; in patients on prior antihypertensive therapy, particularly if this includes a diuretic; and in the elderly. Not all of the actions of ACE inhibitors are necessarily due to lowering of plasma...Continue Reading

Citations

Jul 13, 2005·Progress in Biophysics and Molecular Biology·Shant Der SarkissianMohan K Raizada
Nov 11, 1999·European Journal of Pharmacology·T NakaiK Ichihara
Mar 1, 1993·Clinical and Experimental Hypertension : CHE·V MusumeciP Cherubini
Jul 1, 1993·The American Journal of Emergency Medicine·E C Pigman, J L Scott
Apr 1, 1994·Alimentary Pharmacology & Therapeutics·S HurlimannF Halter

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