Valvo E, Casagrande P, Bedogna V, Antiga L, Alberti D, Zamboni M, Perobelli L, Dal Santo F, Maschio G
Divisione Clinicizzata di Nefrologia, Istituti Ospitalieri di Verona, Italy.
J Hypertens. 1990 Nov;8(11):991-5. doi: 10.1097/00004872-199011000-00003.
Seventeen essential hypertensive patients with normal renal function were treated with a new non-sulphydryl orally active angiotensin converting enzyme (ACE) inhibitor, benazepril, 10 mg given once or twice daily, according to diastolic blood pressure levels, for 6 weeks. In all patients, changes in blood pressure, systemic and renal hemodynamics, plasma renin activity and urinary aldosterone and albumin excretions were assessed at the end of a 2-week placebo run-in period and at the end of the study. Benazepril monotherapy controlled blood pressure well. No changes in cardiac output, heart rate or stroke volume were observed, while peripheral vascular resistance was significantly decreased (-11%, P less than 0.05). Plasma volume was unaltered. The glomerular filtration rate was stable, but effective renal plasma flow was increased because of the marked reduction in renal vascular resistance (-35%) and, therefore, the filtration fraction was decreased. Urinary albumin excretion remained unchanged. A significant increase in plasma renin activity (P less than 0.001) and a decrease in urinary aldosterone excretion were seen. No side effects were observed during the treatment period. In conclusion, our results suggest that benazepril alone is an effective antihypertensive agent in patients with essential hypertension. The blood pressure lowering effect is due mainly to systemic vasodilation and is observed up to 24 h after administration of the drug. The vasodilation appears to be more consistent in the renal than in the systemic circulation.
17名肾功能正常的原发性高血压患者接受了一种新型非巯基口服活性血管紧张素转换酶（ACE）抑制剂贝那普利的治疗，根据舒张压水平，每日服用10mg，每日1次或2次，持续6周。在所有患者中，在为期2周的安慰剂导入期结束时和研究结束时评估血压、全身和肾脏血流动力学、血浆肾素活性以及尿醛固酮和白蛋白排泄的变化。贝那普利单药治疗能很好地控制血压。未观察到心输出量、心率或每搏输出量的变化，而外周血管阻力显著降低（-11%，P<0.05）。血浆容量未改变。肾小球滤过率稳定，但由于肾血管阻力显著降低（-35%），有效肾血浆流量增加，因此滤过分数降低。尿白蛋白排泄保持不变。血浆肾素活性显著增加（P<0.001），尿醛固酮排泄减少。治疗期间未观察到副作用。总之，我们的结果表明，贝那普利单独使用对原发性高血压患者是一种有效的抗高血压药物。血压降低作用主要归因于全身血管舒张，并且在给药后24小时内均可观察到。这种血管舒张在肾脏循环中似乎比在全身循环中更一致。
