Hypotensive Effect of Captopril in Hypertensive Patients with Collagen Disease

• Published in: Nihon Jinzo Gakkai shi Vol. 25; no. 2; pp. 131 - 141
• Main Authors: Fujino, Kazuyuki, Kurata, Noriyuki, Kinashi, Makoto, Takahara, Jiro, Ota, Zensuke, Ofuji, Tadashi
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 01.02.1983
• Subjects: Adolescent; Adult; captopril; Captopril - therapeutic use; collagen disease; Female; Humans; hypertension; Hypertension - drug therapy; Hypertension - etiology; Lupus Erythematosus, Systemic - complications; Male; Middle Aged; Polyarteritis Nodosa - complications; Proline - analogs & derivatives; Renin-Angiotensin System
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.25.131

1-sarcocine, 8-isoleucine-angiotensin II (A II A) was infused intravenously into nine patients with systemic lupus erytematosus (SLE) and two patients with polyarteritis nodosa (PN) at the rate of 200 to 600ng/kg/min after sodium depletion by daily oral administration of 80mg furosemide and sodium restricted diet (NaCl 6-8g/day) for three days. A II A infusion caused reduction in blood pressure (BP) in five SLE patients and all PN patients. This indicates that the renin angiotensin (R-A) system is involved in sustaining hypertension in these patients. The renal small vessel diseases may cause R-A dependent hypertension. The effect of captopril, an orally active angiotensin I - converting enzyme inhibitor, on BP and R-A system was evaluated in these patients. Captopril was administered at the dose of 37.5 to 300mg daily for eight to twenty weeks. Marked reduction of BP was observed in these patients exept one patient with SLE associated with low renin hypertesion. There was a significant correlation between mean BP reduction and basal plasma renin activity (PRA) within one week, but no significant correlation was observed after two weeks. Increase of PRA and decrease of plasma aldosterone concentration were obtained after captopril administration. No significant change was observed in immunological examinations after captopril administration exept for the transient positive reaction in indirect Coombs' test. The present results indicate that hypertension in collagen disease is well controlled by captopril, although it is often refractory to conventional antihypertensive drugs. Captopril may improve tissue blood flow and may be one of the most useful drugs to treat the hypertension in collagen disease.