Key result
Long-term administration of saralasin or converting enzyme inhibitors returned arterial pressure to normal in the second phase of one-clip, two-kidney hypertension.
Why the study?
Do converting enzyme inhibitors or saralasin reduce blood pressure in the second phase of one-clip, two-kidney hypertension?
Do converting enzyme inhibitors or saralasin reduce blood pressure in the second phase of one-clip, two-kidney hypertension?
The study demonstrates that the renin-angiotensin system has an important slow pressor action in the second phase of one-clip, two-kidney hypertension, providing a rational basis for the clinical use of captopril.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for sustained angiotensin II effects in renal hypertension models; leaves open translation to human therapy.
The role of the renin-angiotensin system in the pathogenesis of one-clip, two-kidney hypertension has been studied in man, dog and rat. Particular attention has been paid to peripheral plasma concentrations of angiotensin II in different circumstances; angiotensin II infusion has been combined with radioimmunoassay to construct angiotensin II/blood pressure dose-response curves. The effect of converting enzyme inhibitors has been studied, precautions being taken to avoid obtaining falsely high values for plasma angiotensin II because of cross-reaction with angiotensin I in these circumstances. The initial phase of one-clip, two-kidney hypertension is attributable to the direct pressor effect of the immediate rise in plasma angiotensin II. Subsequently, plasma angiotensin II is relatively lower, although blood pressure remains high. This upward resetting of the plasma angiotensin II/blood pressure relationship can be mimicked by infusing angiotensin II chronically at low dose. After reconstruction of a stenosed renal artery, or excision of a post-stenotic kidney, the angiotensin II/blood pressure relationship returns slowly to normal. In this second phase of one-clip, two-kidney hypertension, the long-term administration of saralasin, or of converting enzyme inhibitor, can also return arterial pressure to normal; brief administration of these drugs is less effective or ineffective. The results are compatible with, although they do not conclusively establish, an important slow pressor action of the renin-angiotensin system in the second phase of one-clip, two-kidney hypertension. This provides a rational basis for the use of captopril clinically in this condition.
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Atkinson et al. (1980) conducted a review in One-clip, two-kidney hypertension. Converting enzyme inhibitors and saralasin was evaluated on Arterial pressure. Long-term administration of saralasin or converting enzyme inhibitors returned arterial pressure to normal in the second phase of one-clip, two-kidney hypertension.
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