Why the study?
Does renin inhibition reduce blood pressure compared to ACE inhibition in sodium-deficient and hypertensive dogs?
Does renin inhibition reduce blood pressure compared to ACE inhibition in sodium-deficient and hypertensive dogs?
In sodium-deficient dogs, renin inhibition lowers blood pressure only at doses much higher than needed to inhibit plasma renin activity, and ACE inhibition appears more efficacious.
Answers are grounded in this paper and cite their sources.
Questions PRA inhibition as primary BP-lowering driver in sodium depletion; leaves open differential ACE vs renin effects in experimental hypertension models.
Mean arterial blood pressure (MAP) was 100 +/- 4 mmHg in a group (n = 3) of conscious sodium-deficient dogs. A 3-day infusion of the renin inhibitor isovaleryl -His-Pro-Phe-His-Sta-Leu-Phe-NH2 (SCRIP) lowered MAP to an average of 79 +/- 4 mmHg. Termination of the infusion resulted in a prompt rise in MAP to 100 +/- 5 mmHg but plasma renin activity (PRA), which was 22 +/- 2 ng angiotensin (Ang) l/ml per h before the infusion, recovered only to 5 +/- 1 ng Ang l/ml per h during the same time (4 h after infusion). In other experiments in sodium-deficient dogs, a direct comparison was made between inhibition of PRA and the reduction of blood pressure. Over the dose range 0.1-2 micrograms/kg per min, PRA was inhibited in a dose-related manner, but MAP was not reduced. At dose levels beginning an order of magnitude higher (e.g. 20-160 g/kg per min), PRA was completely inhibited and there was a dose-related fall in MAP. These data suggest that there is no correlation between inhibition of PRA and the reduction in blood pressure in chronically sodium-deficient dogs. In other studies comparing renin inhibition with angiotensin converting enzyme (ACE) inhibition, there was evidence for greater efficacy of ACE inhibition in conscious sodium-deficient dogs, but no evidence of any difference in one-kidney, one clip hypertensive dogs.
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Edward H. Blaine (1989) studied this question.
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