Effect of Bradykinin-Receptor Blockade on the Response to Angiotensin-Converting–Enzyme Inhibitor in Normotensive and Hypertensive Subjects

• Published in: The New England journal of medicine Vol. 339; no. 18; pp. 1285 - 1292
• Main Authors: Gainer, James V, Morrow, Jason D, Loveland, Angela, King, Debbie J, Brown, Nancy J
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 29.10.1998
• Subjects: ACE inhibitors; Adrenergic beta-Antagonists - pharmacology; Angiotensin-Converting Enzyme Inhibitors - pharmacology; Antihypertensive agents; Antihypertensive Agents - pharmacology; Biological and medical sciences; Blood Pressure - drug effects; Bradykinin - analogs & derivatives; Bradykinin - pharmacology; Bradykinin Receptor Antagonists; Captopril - pharmacology; Cardiovascular system; Diet, Sodium-Restricted; Drug Interactions; Drug Therapy, Combination; Female; Humans; Hypertension; Hypertension - physiopathology; Kidney - drug effects; Losartan - pharmacology; Male; Medical sciences; Pharmacology. Drug treatments; Plasma; Reference Values; Renin-Angiotensin System - drug effects; Single-Blind Method; Human; Hypertension; Blocking; Cardiovascular disease; Receptor potential; Response; Randomization; Placebo; Antihypertensive agent; Influence; Bradykinin antagonist; Hemodynamics; Comparative study; ACE inhibitor
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199810293391804

Angiotensin-converting enzyme (ACE) catalyzes the formation of angiotensin II from angiotensin I and the breakdown of bradykinin into inactive products. 1 ACE inhibitors are widely used in the treatment of hypertension, congestive heart failure, and diabetic nephropathy, and they decrease blood pressure without increasing the heart rate. 2 Given over the short term, they decrease angiotensin II and aldosterone concentrations and increase plasma renin activity. 2 Under most conditions, ACE inhibitors cause natriuresis and increase renal plasma flow without altering the glomerular filtration rate. 3 – 5 The contribution of bradykinin to the actions of ACE inhibitors has been the subject of debate. With long-term . . .