Effect of 9-12 month treatment with captopril on dopplerographic parameters of intrarenal blood flow and renal function was studied in 30 hypertensive diabetics without clinical signs of nephroangiopathy. There was an interrelationship between strict blood pressure (BP) control (average 24-hour BP below 135/83) and improvement of parameters of intrarenal hemodynamics. BP normalization and most pronounced positive changes of renal perfusion during therapy with captopril were achieved in patients with mild hypertension and initially high intrarenal resistance yet at the stage of normo- or microalbuminuria. In moderate hypertension with microalbuminuria treatment with captopril was associated with stabilization of parameters of renal blood flow and rate of 24-hour albumin excretion at their initial level despite less strict control of BP and unsatisfactory compensation of diabetes. BP response to captopril in patients with hypertension and diabetes was related to initial state of intrarenal hemodynamics. In patients with mild hypertension indexes of resistance of renal and intrarenal arteries could be used for prediction of sensitivity to antihypertensive action of captopril.
Adult Angiotensin-Converting Enzyme Inhibitors