Atkinson A B, Brown J J, Cumming A M, Fraser R, Lever A F, Leckie B J, Morton J J, Robertson J I, Davies D L
Am J Cardiol. 1982 Apr 21;49(6):1460-6. doi: 10.1016/0002-9149(82)90361-7.
Fifteen patients with hypertension and unilateral renal artery disease were treated with captopril alone; 10 came to operation and were later assessed postoperatively with no drug treatment. Captopril caused both immediate and sustained decreases in plasma angiotensin II and aldosterone, with increases in plasma active renin and blood angiotensin I concentrations. Decrements in systolic and diastolic pressure 2 hours after the first dose of captopril were closely correlated with the initial decreases in plasma angiotensin II. Blood pressure was decreased by long-term captopril therapy irrespective of whether plasma angiotensin II was abnormally high before treatment. The long-term response of both systolic and diastolic pressure correlated well with the response to surgery. By contrast, the blood pressure decrease 2 hours after the initial dose of captopril variously underestimated and overestimated the decrease during prolonged use of the drug and did not relate to surgical outcome. In patients who, before treatment, had secondary aldosteronism, hyponatremia, hypokalemia and sodium and potassium deficiency, captopril corrected these abnormalities. In the remaining patients, long-term captopril therapy did not alter exchangeable sodium, plasma sodium or total body potassium, although plasma potassium levels increased.
15例高血压合并单侧肾动脉疾病患者单独使用卡托普利治疗；10例接受手术治疗，术后在未进行药物治疗的情况下接受评估。卡托普利可使血浆血管紧张素II和醛固酮立即且持续降低，同时使血浆活性肾素和血血管紧张素I浓度升高。首次服用卡托普利2小时后收缩压和舒张压的下降与血浆血管紧张素II的初始下降密切相关。无论治疗前血浆血管紧张素II是否异常升高，长期使用卡托普利治疗均可使血压降低。收缩压和舒张压的长期反应与手术反应密切相关。相比之下，首次服用卡托普利2小时后的血压下降在长期使用该药物期间对血压下降情况有不同程度的低估和高估，且与手术结果无关。在治疗前有继发性醛固酮增多症、低钠血症、低钾血症以及钠和钾缺乏的患者中，卡托普利纠正了这些异常。在其余患者中，长期使用卡托普利治疗虽使血浆钾水平升高，但并未改变可交换钠、血浆钠或总体钾。
