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      Clinical Pharmacology of ACE Inhibition

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          Abstract

          The radioimmunological determinations of immunoreactive ‘angiotensin IF do not truly reflect angiotensin-(l-8)octapeptide levels, and thus cannot provide an accurate reflection of the efficacy of angiotensin-converting enzyme (ACE) inhibition. Elaborate methods are necessary to measure specifically the octapeptide angiotensin II. This methodology confirms that ACE inhibitors reduce circulating angiotensin II and that tolerance to the angiotensin II-lowering effect of ACE inhibitors does not develop, even after prolonged administration. Furthermore, a marked reduction of angiotensin II levels can be shown even in patients with primary aldosteronism. At peak blockade of ACE, the level of plasma angiotensin II is still related to circulating active renin and angiotensin I. The possible independent role of tissue renin-angiotensin systems in determining vasomotor tone is an interesting hypothesis. However, any discussion of whether tissue or plasma renin determines the pharmacologic effect of ACE inhibitors should be based on the simultaneous measurement of angiotensin-(l-8)octapeptide under steady-state conditions in tissue and plasma.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-5062-8
          978-3-318-01590-4
          0008-6312
          1421-9751
          1989
          1989
          12 November 2008
          : 76
          : Suppl 2
          : 11-22
          Affiliations
          Hypertension Division, University Hospital, Lausanne, Switzerland
          Article
          174555 Cardiology 1989;76:11–22
          10.1159/000174555
          2670217
          © 1989 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 12
          Categories
          ACE-Inhibition: State of the Art

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