Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1981 Nov;46(5):522–527. doi: 10.1136/hrt.46.5.522

Effect of captopril on renal function in patients with congestive heart failure.

G L Pierpont, G S Francis, J N Cohn
PMCID: PMC482690  PMID: 7032555

Abstract

Angiotensin converting enzyme inhibitors can improve haemodynamics in patients with congestive heart failure and may enhance sodium excretion in hypertensive patients. In a metabolic unit we assessed the effects of one of these agents on renal function in nine patients with stable New York Heart Association functional class 3 or 4 congestive heart failure. Single blinded, the patients received placebo for three days, 25 to 100 mg of captopril three times a day for three days, and three more days of placebo. Mean blood pressure decreased during captopril, with little change in heart rate or respiration. Serum urea was slightly higher during captopril administration. The mean change in creatinine clearance during captopril was insignificant, but it decreased more than 25% in three of nine patients. Decreases in creatinine clearance correlated with lower blood pressure during captopril and were most obvious in patients with high baseline plasma renin activity. Urine output and both sodium and potassium excretion decreased during captopril. Thus captopril failed to improve natriuresis in patients with congestive heart failure and close monitoring of kidney function is necessary when using this agent in patients with congestive heart failure, particularly when blood pressure falls to lower levels.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ader R., Chatterjee K., Ports T., Brundage B., Hiramatsu B., Parmley W. Immediate and sustained hemodynamic and clinical improvement in chronic heart failure by an oral angiotensin-converting enzyme inhibitor. Circulation. 1980 May;61(5):931–937. doi: 10.1161/01.cir.61.5.931. [DOI] [PubMed] [Google Scholar]
  2. Atkinson A. B., Morton J. J., Brown J. J., Davies D. L., Fraser R., Kelly P., Leckie B., Lever A. F., Robertson J. I. Captopril in clinical hypertension. Changes in components of renin-angiotensin system and in body composition in relation to fall in blood pressure with a note on measurement of angiotensin II during converting enzyme inhibition. Br Heart J. 1980 Sep;44(3):290–296. doi: 10.1136/hrt.44.3.290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Atlas S. A., Case D. B., Sealey J. E., Laragh J. H., McKinstry D. N. Interruption of the renin-angiotensin system in hypertensive patients by captopril induces sustained reduction in aldosterone secretion, potassium retention and natruiresis. Hypertension. 1979 May-Jun;1(3):274–280. doi: 10.1161/01.hyp.1.3.274. [DOI] [PubMed] [Google Scholar]
  4. Brunner H. R., Gavras H., Waeber B., Kershaw G. R., Turini G. A., Vukovich R. A., McKinstry D. N., Gavras I. Oral angiotensin-converting enzyme inhibitor in long-term treatment of hypertensive patients. Ann Intern Med. 1979 Jan;90(1):19–23. doi: 10.7326/0003-4819-90-1-19. [DOI] [PubMed] [Google Scholar]
  5. Case D. B., Atlas S. A., Mouradian J. A., Fishman R. A., Sherman R. L., Laragh J. H. Proteinuria during long-term captopril therapy. JAMA. 1980 Jul 25;244(4):346–349. [PubMed] [Google Scholar]
  6. Curtiss C., Cohn J. N., Vrobel T., Franciosa J. A. Role of the renin-angiotensin system in the systemic vasoconstriction of chronic congestive heart failure. Circulation. 1978 Nov;58(5):763–770. doi: 10.1161/01.cir.58.5.763. [DOI] [PubMed] [Google Scholar]
  7. Dzau V. J., Colucci W. S., Williams G. H., Curfman G., Meggs L., Hollenberg N. K. Sustained effectiveness of converting-enzyme inhibition in patients with severe congestive heart failure. N Engl J Med. 1980 Jun 19;302(25):1373–1379. doi: 10.1056/NEJM198006193022501. [DOI] [PubMed] [Google Scholar]
  8. Faxon D. P., Creager M. A., Halperin J. L., Gavras H., Coffman J. D., Ryan T. J. Central and peripheral hemodynamic effects of angiotensin inhibition in patients with refractory congestive heart failure. Circulation. 1980 May;61(5):925–930. doi: 10.1161/01.cir.61.5.925. [DOI] [PubMed] [Google Scholar]
  9. Gavras H., Faxon D. P., Berkoben J., Brunner H. R., Ryan T. J. Angiotensin converting enzyme inhibition in patients with congestive heart failure. Circulation. 1978 Nov;58(5):770–776. doi: 10.1161/01.cir.58.5.770. [DOI] [PubMed] [Google Scholar]
  10. Hollenberg N. K., Swartz S. L., Passan D. R., Williams G. H. Increased glomerular filtration rate after converting-enzyme inhibition in essential hypertension. N Engl J Med. 1979 Jul 5;301(1):9–12. doi: 10.1056/NEJM197907053010103. [DOI] [PubMed] [Google Scholar]
  11. Hoorntje S. J., Kallenberg C. G., Weening J. J., Donker A. J., The T. H., Hoedemaeker P. J. Immune-complex glomerulopathy in patients treated with captopril. Lancet. 1980 Jun 7;1(8180):1212–1215. doi: 10.1016/s0140-6736(80)91677-3. [DOI] [PubMed] [Google Scholar]
  12. Maslowski A. H., Ikram H., Nicholls M. G., Espiner E. A. Haemodynamic, hormonal, and electrolyte responses to captopril in resistant heart failure. Lancet. 1981 Jan 10;1(8211):71–74. doi: 10.1016/s0140-6736(81)90004-0. [DOI] [PubMed] [Google Scholar]
  13. Sharpe D. N., Douglas J. E., Coxon R. J., Long B. Low-dose captopril in chronic heart failure: acute haemodynamic effects and long-term treatment. Lancet. 1980 Nov 29;2(8205):1154–1157. doi: 10.1016/s0140-6736(80)92593-3. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES