Korean Journal of Nephrology 1988;7(1):138-146.

신혈관성 고혈압에서 Captopril 검사의 의의

한진석 , 이정상

Abstract

To evaluate the validity as a screening test for identifying renovascular hypertension and other secon- dary hypertension, the blood pressure and responses of plasma renin activity and plasma aldosterone to oral test dose (25 mg) of captopril were studied in the 36 patients clinically suspected for renovascular hyperten- sion. The results obtained were as follows: 1) Among the 36 patients, 18 were with renovascular hypertension (the 10 were due to Takayasus arteritis), 8 with chronic renal failure, 6 with primary aldosteronism (all due to adrenal cortical adenoma), and 4 without any other secondary cause. 2) The reduction of systolic and diastolic pressure at the 90 minutes after captopril was significant in the patients with renovascular hypertension and chronic renal failure (p<0.05). 3) The basal and stimulated plasma renin activities, absolute increase in plasma renin activity after capto- pril, and the ratio of postcaptopril to precaptopril plasma renin activity were significantly high in the patients with renovascular hypertension (p<0.01). 4) The ratio of basal plasma aldosterone to renin activity, plasma aldostone at the 90 minutes after captoril and the ratio of postcaptopril plasma aldoster- one to postcaptoril renin activity were significantly high in the patients with primary aldosteronism (p<0.01). 5) The 3 criteria those mean the hyperresponsiveness of renin secretion in the diagnosis of renovascular hypertension could discriminate from the other causes of hypertension, and the ratio of postcaptopril plasma aldosterone to postcaptopril renin activity could di- scriminated the patients with primary aldosteronism from the other causes. Thus we concluded that oral test of captopril may be a useful screening test for the diagnosis of the renovas- cular hypertension, and since the test also characterizes the renin and aldosterone dependency of the hyperten sion, it may have other diagnositc and therapeutic uses.