Mono- and combined therapy of low-renin hypertension by original enalapril (Renitec) and its effects on renin-angiotensin-aldosteronе system
https://doi.org/10.18705/1607-419X-2009-15-6-671-678
Abstract
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.
About the Authors
Sh. V. Akhadov
Clinical Hospital № 154
Russian Federation
Russian Federation
G. R. Ruzbanova
Clinical Hospital № 81
Russian Federation
Russian Federation
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Review
For citations:
Akhadov Sh.V., Ruzbanova G.R. Mono- and combined therapy of low-renin hypertension by original enalapril (Renitec) and its effects on renin-angiotensin-aldosteronе system. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2009;15(6):671-678. (In Russ.) https://doi.org/10.18705/1607-419X-2009-15-6-671-678
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