Rosenthal Talma
Chorley Institute of Research, Hypertension Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Hypertension Unit, Chaim Sheba Medical Center, Tel Aviv University, Sackler School of Medicine,, Tel Hashomer, 52621, Israel.
Drugs. 1993 Jun;45(6):895-909. doi: 10.2165/00003495-199345060-00003.
The renin-angiotensin system is responsible for renovascular hypertension resulting from narrowing of the renal arteries. Inhibitors of angiotensin-converting enzyme (ACE) interrupt the conversion of angiotensin I to angiotensin II, causing a reduction in blood pressure. Several drugs of this family have been introduced since captopril was launched, including enalapril, lisinopril, ramipril and others. While they are effective antihypertensive agents, they can in some cases lead to deterioration of renal function, especially in patients with bilateral renal artery stenosis or stenosis of a solitary kidney. ACE inhibitors must also be administered with caution to sodium-depleted patients. Calcium antagonists, presumed to be ideal for the treatment of low renin hypertension, have also proved to be effective in patients with renal artery stenosis, many of whom have severe refractory hypertension. These agents, in common with ACE inhibitors, may be useful for determining the lateralisation index used to establish the kidney responsible for hypertension.
肾素-血管紧张素系统导致肾动脉狭窄引发肾血管性高血压。血管紧张素转换酶（ACE）抑制剂可阻断血管紧张素I向血管紧张素II的转化，从而使血压降低。自卡托普利问世以来，已推出了该类别的几种药物，包括依那普利、赖诺普利、雷米普利等。虽然它们是有效的抗高血压药物，但在某些情况下可能导致肾功能恶化，尤其是双侧肾动脉狭窄或孤立肾狭窄的患者。对于低钠患者，使用ACE抑制剂时也必须谨慎。钙拮抗剂被认为是治疗低肾素性高血压的理想药物，在肾动脉狭窄患者中也已证明有效，其中许多患者患有严重的难治性高血压。与ACE抑制剂一样，这些药物可能有助于确定用于确定导致高血压的责任肾的侧化指数。
