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Maintenance of the antihypertensive efficacy of captopril despite consistent reduction in daily dosage.
Author(s) -
Mimran A,
Jover B
Publication year - 1982
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1982.tb02062.x
Subject(s) - captopril , blood pressure , medicine , plasma renin activity , angiotensin converting enzyme , morning , renin–angiotensin system , pharmacology , endocrinology , anesthesia
1 After a period of 7 +/‐ 1.4 months of good control of hypertension by thrice daily administration of captopril (85 +/‐ 9 mg three times a day), captopril was given twice daily and the total dose was progressively reduced to sometimes very low levels in 12 patients. Twice daily administration of captopril 85 +/‐ 9 mg did not modify blood pressure control. 2 During reduction of captopril dosage to a minimum of 36 +/‐ 4 mg twice a day, the acute effect of the morning dose of captopril (last dose taken at least 12 hours before study) was assessed. Administration of the morning dose induced a decrease in mean arterial pressure from 112 +/‐ 4 mm Hg (104 +/‐ 3 mm Hg during administration of 85 +/‐ 9 mg) three times a day to 106 +/‐ 4 mm Hg, an increase in plasma renin activity, and a decrease in plasma aldosterone concentration. 3 These acute effects of captopril suggest that blood pressure was well controlled in the presence of a non‐blocked circulating angiotensin‐converting‐enzyme activity, thus raising the possibility of alternate mechanisms by which captopril reduces arterial pressure. 4 The daily dosage of captopril needed to control hypertension may be reassessed after a certain period of good blood pressure control with 50 to 100 mg captopril three times a day.