Enalapril and the kidney: renal vasodilation and natriuresis due to the inhibition of angiotensin II formation

GJ Navis, D De Zeeuw, PE De Jong - Journal of Cardiovascular …, 1986 - journals.lww.com
GJ Navis, D De Zeeuw, PE De Jong
Journal of Cardiovascular Pharmacology, 1986journals.lww.com
Essential hypertension is characterized by increased renal vascular resistance, which also
has definite implications for renal sodium handling. We studied the possibility of correcting
these abnormalities by inhibiting angiotensin-converting enzyme with enalapril. Enalaprilic
acid produced renal vasodilation. This, particularly postglomerular, vasodilation was
accompanied with an increase in sodium excretion. The natriuresis was positively correlated
to initial plasma renin activity. During continuous treatment with enalapril up to 12 weeks …
Abstract
Essential hypertension is characterized by increased renal vascular resistance, which also has definite implications for renal sodium handling. We studied the possibility of correcting these abnormalities by inhibiting angiotensin-converting enzyme with enalapril. Enalaprilic acid produced renal vasodilation. This, particularly postglomerular, vasodilation was accompanied with an increase in sodium excretion. The natriuresis was positively correlated to initial plasma renin activity. During continuous treatment with enalapril up to 12 weeks, this vasodilation persisted in 22 patients with essential hypertension. We also showed that orally administered enalapril induces natriuresis, both during a 50-mmol and during a 200-mmol sodium intake a day. This natriuresis caused a net negative sodium balance of approximately 120–140 mmol Na after 1 week of enalapril therapy. This was accompanied with a fall in body weight. We conclude that enalapril in essential hypertension alleviates the angiotensin-II-mediated abnormalities in renal hemodynamics and sodium excretion.
Lippincott Williams & Wilkins
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