The role of prostaglandins in mediating the effects of angiotensin converting enzyme inhibitors and other antihypertensive drugs.

This review considers the hypothesis that angiotensin converting enzyme (ACE) inhibitors and other antihypertensive drugs may reduce blood pressure by altering the balance of vasoconstrictor and vasodilator hormones. Most cases of essential hypertension are characterized by increased vascular resistance. Since vascular resistance can be viewed as a net balance of offsetting vasoconstrictor and vasodilator neurohumoral forces, and since angiotensin II and norepinephrine can stimulate the synthesis of vasodilator prostaglandins that can in turn counteract peripheral vasoconstriction, we measured changes in vasoconstrictor (angiotensin II) and vasodilator (PGE2) hormones after giving different antihypertensive drugs. We found that the sulfhydryl containing converting enzyme inhibitor captopril increased vasodilator prostaglandin production (PGE2-metabolite) both acutely and chronically. This increase in PGE2-metabolite was not seen with the non-sulfhydryl converting enzyme inhibitor, enalapril.