Document Detail

Response to the captopril test is dependent on baseline renin profile.
MedLine Citation:
PMID:  8021469     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine prospectively the relationship between the renin-sodium profile and the renin response to captopril challenge in patients with essential hypertension. DESIGN: A standard captopril test was performed in 108 uncomplicated, untreated hypertensive subjects with normal renal function and urinary sodium excretion in the range 50-240 mmol/day. The subjects were selected from a working population with a low expected prevalence of renovascular disease. METHOD: The captopril test was considered positive if the captopril-induced rise in plasma renin activity met all three criteria established by Müller et al. Patients with a positive test and those meeting only one or two of the three criteria were further investigated for renovascular hypertension by measuring renal venous renins and by digital subtraction intravenous angiography. Renin responses were analyzed according to baseline renin-sodium profile. RESULTS: Nine of 108 subjects had a false-positive captopril test result. Among the subjects with a low or normal renin-sodium profile, 1% (one of 82) had a false-positive result. In contrast, false-positive results were seen in 31% (eight of 26) of high-renin subjects. False-positive test results were not related to urinary sodium excretion or to excessive decrease in blood pressure. The magnitude of the renin response to captopril was strongly and directly related to the baseline plasma renin activity. CONCLUSION: An exaggerated renin response to captopril challenge is common in patients with high-renin essential hypertension. Therefore, in a population with a low probability of renovascular hypertension, caution is recommended in interpreting a positive test result in patients with a high baseline renin.
L M Gerber; S J Mann; F B Müller; M H Alderman; T G Pickering; J E Sealey; J H Laragh
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of hypertension     Volume:  12     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-07-29     Completed Date:  1994-07-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  173-8     Citation Subset:  IM    
Cardiovascular Center, New York Hospital-Cornell Medical Center, NY 10021.
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MeSH Terms
Angiography, Digital Subtraction
Blood Pressure / drug effects
Captopril / diagnostic use*
False Positive Reactions
Hypertension / blood,  urine
Hypertension, Renovascular / blood*,  diagnosis*,  radiography
Middle Aged
Prospective Studies
Renin / blood*
Sodium / urine
Grant Support
Reg. No./Substance:
62571-86-2/Captopril; 7440-23-5/Sodium; EC

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