Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.11.18 (MAP)
 7,412 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Deterioration of renal function may be elicited by converting enzyme inhibition (CEI) in patients with bilateral (BI) or solitary kidney (SK) renal artery stenosis, but the determinants of this complication are not clearly delimited. The effect of acute administration of captopril on arterial pressure, glomerular filtration rate (GFR) and effective renal plasma flow was assessed in 10 BI and 10 SK hypertensive patients with a mean GFR of 64 +/- 5 ml/min. CEI induced a decrease in MAP of 8 +/- 2 p. 100 and a fall in GFR of 25 +/- 8 p. 100; GFR fell by more than 20 p. 100 in 5/10 BI and 8/10 SK. Filtration fraction (FF) decreased by 16 +/- 5 p. 100. CEI-induced change in GFR was not related to the change in MAP, but was inversely correlated with pre-C FF; GFR always fell when FF was higher than 0.28. Surgical correction of the stenosis suppressed the C-induced decrease in GFR in 5 SK patients in whom it initially fell. In conclusion, basal FF, a probable index of intrarenal angiotensin II activity, rather than a fall in systemic blood pressure, is the main predictor of acute deterioration of renal function after converting enzyme inhibition.
 ...
PMID:[Determinant factors in the acute functional deterioration caused by the inhibition of the conversion enzyme in reno-vascular arterial hypertension]. 311 87

The aim of the study was to evaluate the effect of angiotensin converting enzyme inhibition on blood pressure and plasma renin activity (PRA) in patients with essential (EH) and renovascular (RVH) hypertension. Forty patients with RVH and sixty four with EH were studied. All patients underwent renal digital subtraction angiography in order to find out renal artery stenosis. Blood pressure was measured before and 15, 30, 45, 60 and 90 minutes after captopril administration in the captopril test. PRA was determined before and 60 minutes after captopril. It was shown that fall of systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure after captopril was significant in each time period both in EH and RVH. Hypotensive effect was significantly higher (p < 0.001) in RVH. Basic PRA did not differ in the studied groups. 60 minutes after captopril administration PRA was significantly higher (p < 0.001) in patients with RVH. Absolute and percentage rise of PRA also differentiated studied groups (p < 0.001). Significant correlations were found between the change of PRA after captopril and fall of SAP, DAP and MAP in both groups. These relationships were stronger in RVH.
 ...
PMID:[Usefulness of converting enzyme inhibitors in diagnosis of renovascular hypertension. I. Comparison of the effect of angiotensin converting enzyme inhibition on blood pressure and plasma renin activity in patients with primary hypertension and renovascular hypertension]. 938 Aug 5

We evaluated whether there was a clinical outcome benefit in patients incidentally discovered to have high-grade renal artery stenosis (RAS) and treated with percutaneous transluminal renal angioplasty and stenting (PTRAS) at the time of angiogram for another indicated procedure. A retrospective chart review was performed on all patients undergoing renal arteriography over 4 years at our academic tertiary-care referral center. Review of catheterization reports was used to identify patients diagnosed with high-grade RAS (reduction of > or =70% luminal diameter by arteriogram). Patients treated with PTRAS were identified. Baseline and postprocedure blood pressure (BP, an average of at least three independent measurements), glomerular filtration rate, serum creatinine, and antihypertensive medication regimen were compared for 12 months of follow-up. Over 4 years, 124 patients underwent renal arteriography and 78 (63%) were diagnosed with high-grade RAS. Fifty-eight patients (74% of those with high-grade RAS) received PTRAS. Patients treated with PTRAS had similar baseline characteristics to those with high-grade RAS with no intervention, with the exception of lower diastolic BP (DBP; 74 +/- 11.2 vs. 80 +/- 14.2 mm Hg, p = 0.04) and a higher proportion of hyperlipidemia (78 vs. 55%, p = 0.05). Thirty-eight out of 58 PTRAS patients (66%) received sufficient follow-up to assess outcomes. When baseline and postprocedure variables were compared in PTRAS patients with 12-month follow-up, there was a reduction in systolic BP (SBP, 153 +/- 20.8 vs. 136 +/- 27.2 mm Hg, p = 0.01) and mean arterial pressure (MAP, 103 +/- 11.2 vs. 95 +/- 14 mm Hg, p = 0.04). When these patients were stratified by those with an increase, decrease, or no change in postprocedure antihypertensive medications, significant reductions in SBP, MAP, and DBP were noted only in the patient population that also had an increase in the number of antihypertensive medications. No differences in renal insufficiency were detected. Patients with high-grade RAS incidentally discovered during arteriography performed for extrarenal disease and treated with PTRAS have a modest reduction in BP, which is significant only in those patients with an increased number of antihypertensive medications postprocedure. Caution must be taken in stenting patients with incidental RAS as outcome benefit may be minimal when compared to medical management only.
 ...
PMID:Renal stenting for incidentally discovered renal artery stenosis: is there any outcome benefit? 1862 Jan 11