Open AccessMono- and combined therapy of low-renin hypertension by original enalapril (Renitec) and its effects on renin-angiotensin-aldosteronе system
Author(s) -
Ш. В. Ахадов,
Г. Р. Рузбанова
Publication year - 2009
Publication title -
arterialʹnaâ gipertenziâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.126
H-Index - 5
eISSN - 2411-8524
pISSN - 1607-419X
DOI - 10.18705/1607-419x-2009-15-6-671-678
Subject(s) - enalapril , plasma renin activity , aldosterone , renin–angiotensin system , blood pressure , medicine , endocrinology , chemistry , essential hypertension , urology , angiotensin converting enzyme
Objective. To estimate efficiency of original enalapril Renitec in patients with low-renin hypertension (NR АH). Design and methods. 202 patients with NR АH were recruited. The mean systolic blood pressure (BP) was 196,6 ± 6,2 mmHg, diastolic BP - 112,4 ± 5,6 mmHg . Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were estimated by radio-immune method in active patients. PRA was rated as normal if ranged 1,0-3,0 ng/ml/h, PA - 0,18-0,83 nmol/l (5-23 ng/dl or 50-230 pg/ml). Normal PA/PRA ratio was 5-23. Conclusion. 1) Nonstimulation renin criterion in the test with 20 mg/day enalapril (Renitec) intake is the impossibility of PRA increase more than 1,0 ng/ml/h, and angiotensindependent BP criterion is the decrease of PAC and/or PAC:PRA more than 20 % from the baseline level. 2) The primary task of NR АH treatment is the normalization of indicators of rennin-angitensin-aldosterone system and the achieving of target BP. Treatment should be started with monotherapy 20 mg/day enalapril (Renitec) intake. If PAC: PRA is normal but BP is still elevated a calcium blocker should be added. If PAC:PRA is abnormal after enalapril monotherapy then a low daily dose of spironalactone is added.