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Successful acute and long-term treatment of renin-induced hypertension in two infants with captopril

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Abstract

Captopril, an orally active inhibitor of angiotensin-converting-enzyme, offers a new approach in the treatment of renin-induced hypertension, which is refractory to conventional drugs. A 4 months old infant developed after nephrectomy again hypertension which was probably renin-induced. BP did not respond to high doses of methyl-dopa, clonidine, hydralazine, and furosemide. An acute BP response to captopril was seen at a daily dose of 150 mg. During long-term treatment, 75 mg captopril and 12.5 mg hydrochlorothiazide resulted in normalization of BP. In a second child with renin-induced hypertension since the firth month of life, treatment wiht hydralazine, clonidine and hydrochlorothiazide was in part effective, but failure to thrive was progressive. Captopril treatment was started at the age of 20 months. BP was lowered at a daily dose of 75 mg and normalized during long-term therapy with 50 mg. Side effects were not seen.

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References

  1. Asaa MM, Antonaccio MJ (1979) The effects of captopril (SQ 14.225) on vascular tissue renin in spontaneously and WKY-normotensive rats. Relationship to systolic blood pressure and plasma renin activity (Abstract). Pharmacologist 21:212

    Google Scholar 

  2. Atkinson AB, Robertson JIS (1979) Captopril in the treatment of clinical hypertension and cardiac failure. Lancet II: 836–839

    Google Scholar 

  3. Atlas SA, Case DB, Sealey JE, Laragh JH, McKinstry DK (1979) Interruption of the renin-angiotensin system in hypertensive patients by captopril induces sustained reduction in aldosterone secretion, potassium retention and natriuresis. Hypertension 1:274–280

    Google Scholar 

  4. Van Brummelen P, Willemze R, Tan WD, Thomson J (1980) Captopril-associated agranulocytosis. Lancet I:150

    Google Scholar 

  5. Brunner HR, Gavras H, Waeber B, Kershaw GR, Turini GA, Vukovich RA, McKinstry D, Gavras I (1979) Oral angiotensin-converting-enzyme inhibitor in long-term treatment of hypertensive patients. Ann Intern Med 90:19–23

    Google Scholar 

  6. Case DB, Atlas SA, Laragh JH, Sealey JE, Sullivan PA, McKinstry DN (1978) Clinical experience with blockade of the renin-angiotensin-aldosterone system by an oral converting enzyme inhibitor (SQ 14,225, Captopril) in hypertensive patients. Progr Card Dis 21:195–206

    Google Scholar 

  7. Colman RW, Girey GJD, Zacest R (1971) The human plasma kallikrein-kinin system. Prog Hematol 7:225–298

    Google Scholar 

  8. Erdös E (1975) Angiotensin I converting enzyme. Circ Res 37:138–148

    Google Scholar 

  9. Ferguson RK, Turini GA, Brunner HR, Gavras H (1977) A specific orally active inhibitor of angiotensin-converting enzyme in man. Lancet I:775–778

    Google Scholar 

  10. Gavras H, Brunner HR, Turini GA, Kershaw GR, Tifft GP, Cuttelod S, Gavras I, Vukovich RA, McKinstry DN (1978) Antihypertensive effect of the oral antiotensin-converting-enzyme inhibitor SQ 14,225 in man. N Engl J Med 298:991–995

    Google Scholar 

  11. Hoorntje SJ, Weening JJ, Kallenberg CGM, Prins EJL, Donker AJM (1979) Serum-sickness-like syndrome with membranous glomerulopathy in patients on captopril. Lancet II:1297

    Google Scholar 

  12. Johnston CI, Millar JA, McGrath BP, Matthews PG (1979) Long-term effects of captopril (SQ 14,225) on blood pressure and hormone levels in essential hypertension. Lancet II:493–495

    Google Scholar 

  13. Makker SP (1975) Minoxidil in refractory hypertension. J Pediat 86:621–623

    Google Scholar 

  14. McCaa RE (1979) The hypotensive and natriuretic action of captopril is due to inhibition of angiotensin II formation. Kidney Int 16:794

    Google Scholar 

  15. Mimram A, Brunner HR, Turini GA, Waeber B, Brunner D (1979) Effect of captopril on renal vascular tone in normal subjects and in patients with essential hypertension. Abstracts 6th scientific meeting of the International Society of Hypertension, Göteborg, p 158

  16. Oberfield SE, Case DB, Levine LS, Rapaport R, Rauh W, New MI (1979) Use of the oral angiotensin-I-converting enzyme inhibitor (captopril) in childhood malignant hypertension. J Pediat 95:641–644

    Google Scholar 

  17. Ondetti MA, Rubin B, Cushman DW (1977) Design of specific inhibitors of angiotensin-converting-enzyme: new class of orally active antihypertensive agents. Science 196: 441–444

    Google Scholar 

  18. Pennisi AJ, Takahashi M, Bernstein BH, Singsen BH, Uittenbogaart C, Ettenger RB, Melekzadeh MH, Hanson V, Fine RN (1977) Minoxidil therapy in children with severe hypertension. J Pediat 90:813–819

    Google Scholar 

  19. Prins EJL, Hoorntje SJ, Weening JJ, Donker AJM (1979) Nephrotic syndrome in patient on captopril. Lancet II: 286–288

    Google Scholar 

  20. Sinako AR, Mirkin BL (1978) Management of severe childhood hypertension with minoxidil: a controlled clinical study. J Pediat 91:138–142

    Google Scholar 

  21. Swales JD (1979) Arterial wall or plasma renin in hypertension. Clin Sci 56:293–298

    Google Scholar 

  22. Vlasses PH, Ferguson RK (1979) Temporary ageusia related to captopril. Lancet II:526

    Google Scholar 

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Rosendahl, W., Hayduk, K. Successful acute and long-term treatment of renin-induced hypertension in two infants with captopril. Eur J Pediatr 135, 161–164 (1980). https://doi.org/10.1007/BF00441635

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  • DOI: https://doi.org/10.1007/BF00441635

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