Reduction of Sympathetic Hyperactivity by Enalapril in Patients with Chronic Renal Failure

• Published in: The New England journal of medicine Vol. 340; no. 17; pp. 1321 - 1328
• Main Authors: Ligtenberg, Gerry, Blankestijn, Peter J, Oey, P. Liam, Klein, Inge H.H, Dijkhorst-Oei, Lioe-Ting, Boomsma, Frans, Wieneke, George H, van Huffelen, Alexander C, Koomans, Hein A
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 29.04.1999
• Subjects: Amlodipine - pharmacology; Amlodipine - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - pharmacology; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Baroreflex - drug effects; Biological and medical sciences; Blood pressure; Calcium Channel Blockers - pharmacology; Calcium Channel Blockers - therapeutic use; Drug therapy; Enalapril - pharmacology; Enalapril - therapeutic use; Female; Humans; Hypertension; Hypertension - drug therapy; Hypertension - etiology; Hypertension - physiopathology; Kidney diseases; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - drug therapy; Kidney Failure, Chronic - physiopathology; Male; Medical sciences; Middle Aged; Muscles - innervation; Pharmacology. Drug treatments; Reference Values; Renin - blood; Studies; Sympathetic Nervous System - drug effects; Urinary system; Kidney disease; Human; Hypertension; Urinary system disease; Hyperactivity; Treatment efficiency; Cardiovascular disease; Sympathetic nervous system; Long term; Chronic; Reduction; Enalapril; Renal failure; Antihypertensive agent; Pharmacokinetics; Therapeutic protocol; ACE inhibitor; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199904293401704

Patients with essential hypertension, 1 , 2 accelerated hypertension, 3 or chronic renal failure 4 have increased sympathetic activity, which contributes not only to their hypertension but also to atherogenesis and cardiac hypertrophy. 5 , 6 In patients with congestive heart failure, sympathetic overactivity is associated with a poor prognosis and an increased risk of cardiac arrhythmias and sudden death. 7 , 8 Angiotensin-converting–enzyme (ACE) inhibitors and calcium-channel blockers are widely used in all these conditions to lower blood pressure or improve cardiac function, but whether these two classes of drugs differ in their ability to control sympathetic overactivity is not known. ACE inhibition is accompanied by a . . .