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May 1, 1981Clinical Science

Captopril Combined with Thiazide Lowers Renin Substrate Concentration: Implications for Methodology in Renin Assays

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Why the study?

Does treatment with captopril, hydrochlorothiazide, and propranolol alter plasma concentrations of renin and angiotensins in patients with severe or malignant hypertension?

Population

9 patients with severe or malignant hypertension

Design

Case_series

Authors

SRSten RasmussenAalborg University HospitalMNMeta Damkjær NielsenRigshospitaletJGJ. GieseAarhus Municipality

Discussion

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Overview

May alter PRA assay validity during captopril therapy; leaves open whether direct renin concentration should replace PRA in monitoring.

Key Points

  • To evaluate the impact of combined captopril and hydrochlorothiazide therapy on plasma renin, renin substrate, and angiotensin concentrations, and assess its methodological implications for renin assays.
  • Evaluated 9 patients with severe or malignant hypertension undergoing combination therapy with captopril, hydrochlorothiazide, and propranolol.
  • Measured plasma concentrations of renin, renin substrate, angiotensin I, and angiotensin II, alongside plasma renin activity (PRA).
  • Treatment with captopril and hydrochlorothiazide markedly reduced plasma concentrations of renin substrate and angiotensin II while increasing renin and angiotensin I levels.
  • Substrate depletion profoundly alters plasma renin activity assays, indicating that direct plasma renin concentration measurements are necessary to monitor renin release accurately during treatment.

Structured PICO

Does treatment with captopril, hydrochlorothiazide, and propranolol alter plasma concentrations of renin and angiotensins in patients with severe or malignant hypertension?

P
Population
9 patients with severe or malignant hypertension
I
Intervention
Treatment with captopril, hydrochlorothiazide, and propranolol
O
Outcome
Plasma concentrations of renin, renin substrate, angiotensins I and II, and plasma renin activitysurrogate

During captopril treatment, sequential changes in renin release should be monitored by measuring plasma renin concentration rather than plasma renin activity due to marked changes in renin substrate concentration.

Cite This Study

Rasmussen et al. (1981) studied this question.

synapsesocial.com/papers/6a7323ce9114ba2b47c231cahttps://doi.org/10.1042/cs0600591

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The renin‐angiotensin system during converting enzyme inhibition with captopril in patients with severe treatment‐resistant hypertension1984 · 7 citations
  2. 2Captopril treatment: inter‐dose variations in renin, angiotensins I and II, aldosterone and blood pressure.1982 · 14 citations
  3. 3The Effect of Captopril on Renal Hemodynamics in Hypertensive Patients1984 · 15 citations
  4. 4Differential Effects of Diuresis and Beta‐Adrenoreceptor Blockade During Angiotensin‐Converting Enzyme Inhibition in Patients with Severe Hypertension1982 · 11 citations
  5. 5Use of Captopril in the Diagnosis of Renal Hypertension1981 · 16 citations