May 1, 1999

The effects of ramipril on sympathetic nervous system function in older patients with hypertension

Clinical Pharmacology and Therapeutics
C C LeeM A Supiano


There are important interactions between the renin-angiotensin system and the sympathetic nervous system. Therapy with angiotensin-converting enzyme (ACE) inhibitors may suppress sympathetic nervous system activity. To test the hypothesis that long-term ACE inhibition by ramipril will suppress sympathetic nervous system activity and up-regulate alpha-adrenergic receptor responsiveness in older patients with hypertension. This placebo-controlled, double-blind randomized study was conducted at the University Hospital, General Clinical Research Center, University of Michigan Medical Center. Fifteen healthy older patients with mild to moderate hypertension received 8 weeks of ramipril therapy with doses ranging from 5 mg to 20 mg. The following measurements were obtained: plasma norepinephrine levels; norepinephrine kinetic parameters derived from plasma norepinephrine and 3H-norepinephrine levels obtained during infusion and disappearance of 3H-norepinephrine, including the extravascular norepinephrine release rate, norepinephrine clearance, spillover fraction, and volume of distribution; forearm blood flow; platelet membrane alpha2-receptor binding characteristics, and adenylyl cyclase activity. Although plasma norepinephrine lev...Continue Reading

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Mentioned in this Paper

Blood Flow Velocity
Norepinephrine, (+, -)-Isomer
Hypertensive Disease
Antihypertensive Agents
Achard-Thiers Syndrome
Angiotensin-Converting Enzyme Inhibitors

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