Key result
Acute captopril is linked to a ~23% GFR decrease in renovascular hypertension versus nifedipine.
Why the study?
Determinants of renal function deterioration induced by ACE inhibition in renovascular hypertension were not well characterized, especially comparing effects of ACEI and calcium antagonists.
Does acute administration of captopril compared to nifedipine worsen renal function in patients with renovascular hypertension?
Does acute administration of captopril compared to nifedipine worsen renal function in patients with renovascular hypertension?
Calcium antagonists may be preferred over ACE inhibitors in patients with bilateral renal artery stenosis or stenosis of a solitary kidney to better maintain renal function when lowering blood pressure.
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May favor calcium antagonists over ACE inhibitors to preserve renal function in renovascular hypertension; hypothesis-generating from Level 3 data and needs randomized confirmation.
Ribstein et al. (1988) studied Renovascular hypertension (n=22). Captopril vs. Nifedipine was evaluated on Change in glomerular filtration rate. Acute administration of captopril decreased glomerular filtration rate by 23±12% in patients with renovascular hypertension, whereas nifedipine was associated with a 13±5% change.
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