Why the study?
Does Spirapril improve renal hemodynamics and blood pressure in patients with essential hypertension?
Does Spirapril improve renal hemodynamics and blood pressure in patients with essential hypertension?
Spirapril effectively controls blood pressure while preserving renal function and reducing urinary albumin excretion in patients with essential hypertension.
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Renal benefits with spirapril in hypertension remain hypothesis-generating; should not change practice without randomized confirmation.
Sixteen essential hypertensive patients were entered into a protocol assessing the effect of Spirapril, an angiotensin-converting enzyme (ACE) inhibitor, on blood pressure, the renin-aldosterone system, and renal function. Specifically monitored before, during 6 weeks, and 6 months of Spirapril therapy were plasma renin activity, plasma aldosterone, serum ACE, the renal clearances of creatinine, inulin, and para-aminohippurate, and urinary albumin excretion. Blood pressure was well controlled. Spirapril stimulated plasma renin activity and suppressed ACE throughout the entire protocol. Renal clearances were unchanged. Renal vascular resistance was decreased. Urinary albumin excretion was decreased. The authors conclude that the ACE inhibitor, Spirapril, when used as an effective antihypertensive agent, preserves renal function, lowers renal vascular resistance, and decreases urinary albumin excretion.
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Reams et al. (1993) studied this question.
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