Warner N J, Rush J E
Merck Sharp & Dohme Research Laboratories, Rahway, New Jersey.
Drugs. 1988;35 Suppl 5:89-97. doi: 10.2165/00003495-198800355-00016.
This review will discuss the safety profiles of the angiotensin-converting enzyme (ACE) inhibitors captopril, enalapril and lisinopril in patients with hypertension. In general, the safety profiles of ACE inhibitors compare favourably with those of other agents used for the treatment of hypertension. Adverse effects are not common when ACE inhibitors are used at the currently recommended doses. The adverse experiences that do occur with ACE inhibitors can be divided into 3 categories. Hypotension, hyperkalaemia and renal impairment are related directly to the blockade of the angiotensin-converting enzyme. Attention to the clinical condition, including concomitant therapy, reduces the risk of these adverse effects of ACE inhibition. Other adverse effects such as cough and angioedema also occur with all ACE inhibitors. The mechanisms are poorly understood, making it difficult to predict in which patients they will occur. Adverse effects such as rash, dysgeusia, neutropenia and proteinuria, which were reported relatively frequently in the early experience with captopril, are reported less frequently with lower doses of captopril and do not appear to be a problem with other ACE inhibitors such as enalapril and lisinopril.
本综述将讨论血管紧张素转换酶（ACE）抑制剂卡托普利、依那普利和赖诺普利在高血压患者中的安全性概况。总体而言，ACE抑制剂的安全性与用于治疗高血压的其他药物相比具有优势。按照目前推荐剂量使用ACE抑制剂时，不良反应并不常见。ACE抑制剂确实会出现的不良经历可分为3类。低血压、高钾血症和肾功能损害与血管紧张素转换酶的阻断直接相关。关注临床状况，包括联合治疗，可降低ACE抑制这些不良反应的风险。其他不良反应，如咳嗽和血管性水肿，在所有ACE抑制剂中也会出现。其机制尚不清楚，因此很难预测哪些患者会出现这些不良反应。皮疹、味觉障碍、中性粒细胞减少和蛋白尿等不良反应，在卡托普利早期使用经验中报告相对频繁，使用较低剂量卡托普利时报告较少，并且似乎不是依那普利和赖诺普利等其他ACE抑制剂的问题。
