Platelet Angiotensin II in Cerebrovascular Accident and the Effect of Angiotensin-Converting Enzyme Inhibitors

Platelet angiotensin II concentrations were significantly (P less than 0.01) elevated in 16 patients with a history of cerebral infarction, compared with 12 control subjects. The angiotensin-converting enzyme inhibitors, captopril, enalapril and delapril hydrochloride, were evaluated in 20 hypertensive patients with a history of cerebral infarction. Each agent was administered orally each day for 12 weeks using an open randomized crossover design. After 4 weeks' treatment, 75 mg/kg captopril significantly (P less than 0.01) increased platelet angiotensin II concentrations and the increase was maintained for a further 8 weeks. Treatment with 5 mg/day enalapril resulted in no significant change in angiotensin II. Treatment with 30 mg/day delapril hydrochloride significantly (P less than 0.05) decreased platelet angiotensin II concentrations at 4 weeks and the change persisted for 12 weeks (P less than 0.01). During delapril hydrochloride treatment platelet angiotensin II concentrations approached normal values. It is concluded that delapril hydrochloride may be used to treat patients with arteriosclerosis disorders and may inhibit the tendency for atherosclerotic changes and thrombosis.