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January 1, 1985Folia Endocrinologica Japonica2 citationsOpen Access

The Acute Effects of the New Angiotensin I-Converting Enzyme Inhibitor, Enalapril Maleate, on Blood Pressure, Plasma Renin, Aldosterone and Kinins in Hypertensive Patients

MGMitsuhiro GOTOHKMKenji MizunoSHShigeatsu Hashimoto

Key Result

A single 10 mg oral dose of enalapril maleate significantly lowered mean blood pressure in both low-renin and normal/high-renin hypertensive patients, with maximal reduction occurring at 4 hours post-administration.

PICO

P
Population
20 hypertensive patients (mean age 42.2 years, 40% female) were evaluated for the acute hemodynamic and hormonal effects of a single oral dose of enalapril maleate over 24 hours.
I
Intervention / Comparator
Enalapril maleate vs Baseline (pre-treatment) (10 mg)
O
Primary Outcome
Reduction in mean blood pressure at 4 hours post-dose, p=<0.001

Main Result

p-value: p=<0.001

Limitations

  • Small sample size
  • Lack of a placebo control group
  • Short follow-up duration limited to acute effects over 24 hours

Abstract

The acute antihypertensive effect of a new long-acting oral angiotensin I-converting enzyme (ACE) inhibitor, enalapril maleate, was assessed in 20 hypertensive patients, of whom 14 had essential hypertension, 4 had renovascular hypertension, one had hypertension associated with chronic renal failure, and one had primary aldosteronism. Enalapril maleate significantly lowered the blood pressure in either low-renin or normal- and high-renin hypertensives. There was a significant correlation for all patients as a group between the pretreatment levels of serum ACE activity and the reduction in mean blood pressure (r = -0.454, p less than 0.05, n = 20) 2 h after drug administration. The serum ACE activity decreased maximally 3 to 4 hours after drug administration and did not return to baseline levels within 24 h. There was a significant correlation between the reduction in mean blood pressure and changes in ACE activity 90 min and 2 h after drug administration, respectively, for all patients as a group (r = 0.495, p less than 0.05, n = 20, at 90 min; r = 0.508, p less than 0.05, n = 20, at 2 h). The plasma renin activity (PRA) significantly increased in normal- and high-renin hypertensives but not in low-renin hypertensives. There was a close correlation between the reduction in mean blood pressure and the PRA 8 h after drug administration in normal- and high-renin patients (r = -0.623, p less than 0.05, n = 13), while no such relationship was observed in low-renin patients. The plasma aldosterone concentration (PAC) significantly decreased within 3 h, the lowest values occurring at 8 h after drug administration, and it returned to baseline levels within 24 h in all patients. No relationship was found between the reduction in mean blood pressure and changes in PAC after drug administration in either low-renin or normal- and high-renin hypertensives. The plasma bradykinin concentration (PBC) increased within 1 h, the highest values occurring at 3 h after drug administration, and returned to baseline levels within 24 h in low-renin hypertensives, while the PBC was significantly increased at 4 h and had not returned to baseline levels within 24 h in normal- and high-renin hypertensives. There was a significant correlation between percentage changes in mean blood pressure and those in PBC 90 min after drug administration in normal- and high-renin hypertensives (r = -0.556, p less than 0.05, n = 13), while no relationship was observed between them in low-renin hypertensives.(ABSTRACT TRUNCATED AT 400 WORDS)

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Cite This Study

GOTOH et al. (1985) studied Hypertension (n=20). Enalapril maleate vs. Baseline (pre-treatment) was evaluated on Reduction in mean blood pressure at 4 hours post-dose (p=<0.001). A single 10 mg oral dose of enalapril maleate significantly lowered mean blood pressure in both low-renin and normal/high-renin hypertensive patients, with maximal reduction occurring at 4 hours post-administration.

synapsesocial.com/papers/6a9ca0dbb04753c1bc57a2cehttps://doi.org/10.1507/endocrine1927.61.5_619
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