Converting enzyme inhibition in hypertensive emergencies.

Abstract:

:The diagnostic and therapeutic value of the angiotensin converting enzyme inhibitor teprotide (SQ 20881) was assessed in 18 patients with hypertensive emergencies. Mean blood pressure fell 31 +/- 18 mm Hg in the 10 subjects who responded to 1 mg/kg body weight administered intravenously, whereas it fell 5 +/- 3 mm Hg in the eight nonresponders. In patients who had received no previous drug treatment, log baseline plasma renin activity and change in mean blood pressure after SQ 20881 correlated significantly (r = 0.651, P less than 0.05). After acute therapy with SQ 20881, the patients who had a satisfactory response to the drug were treated with propranolol and a relatively normal sodium intake (88 meq/day). Nonresponders were treated with diuretics and sodium restriction (10 meq/day), and intermediate responders were given combination therapy. Mean blood pressure responded favorably within 24 h to the chosen regimen for each group from 152 +/- 47 to 102 +/- 31 mm Hg. SQ 20881 allows prompt evaluation of the role of renin in hypertensive emergencies and permits early choice of appropriate therapy based on the prevailing mechanism.

journal_name

Ann Intern Med

authors

Tifft CP,Gavras H,Kershaw GR,Gavras I,Brunner HR,Liang CS,Chobanian AV

doi

10.7326/0003-4819-90-1-43

subject

Has Abstract

pub_date

1979-01-01 00:00:00

pages

43-7

issue

1

eissn

0003-4819

issn

1539-3704

journal_volume

90

pub_type

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