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- Title
Converting enzyme inhibition in hypertensive emergencies.
- Authors
Tifft, Charles P.; Gavras, Haralambos; Kershaw, Glenn R.; Gavras, Irene; Brunner, Hans R.; Chang-Seng Liang; Chobanian, Aram V.; Tifft, C P; Gavras, H; Kershaw, G R; Gavras, I; Brunner, H R; Liang, C S; Chobanian, A V
- Abstract
The diagnostic and therapeutic value of the angiotensin converting enzyme inhibitor teprotide (SQ 20881) was assessed in 18 patients with hypertensive emergencies. Mean blood pressure fell 31 +/- 18 mm Hg in the 10 subjects who responded to 1 mg/kg body weight administered intravenously, whereas it fell 5 +/- 3 mm Hg in the eight nonresponders. In patients who had received no previous drug treatment, log baseline plasma renin activity and change in mean blood pressure after SQ 20881 correlated significantly (r = 0.651, P less than 0.05). After acute therapy with SQ 20881, the patients who had a satisfactory response to the drug were treated with propranolol and a relatively normal sodium intake (88 meq/day). Nonresponders were treated with diuretics and sodium restriction (10 meq/day), and intermediate responders were given combination therapy. Mean blood pressure responded favorably within 24 h to the chosen regimen for each group from 152 +/- 47 to 102 +/- 31 mm Hg. SQ 20881 allows prompt evaluation of the role of renin in hypertensive emergencies and permits early choice of appropriate therapy based on the prevailing mechanism.
- Subjects
ACE inhibitors; THERAPEUTICS; HYPERTENSION; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; MEDICAL emergencies; OLIGOPEPTIDES; RENIN; RESEARCH; VASODILATORS; EVALUATION research; PROPRANOLOL
- Publication
Annals of Internal Medicine, 1979, Vol 90, Issue 1, p43
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-90-1-43