腎性高血圧症に対するAngiotensin I converting enzyme inhibitor(SQ 14225)の使用経験

Abstract

Three hypertensive patients with plasma renin hyperactivity were treated with orally-active inhibitor of angiotensin I converting enzyme, SQ 14225. In two patients, case 1 and 3, surgical therapy was not indicated according to the renal vein renin determination. In the other patient, case 2, right partial nephrectomy was carried out, but the arterial blood pressure failed to fall for several months after the operation. In response to first oral administration of 100 mg of SQ 14225, arterial blood pressure decreased from 168/106 to 120/84 mmHg in case I, from 166/88 to 106/76 mmHg in case 2, from 184/84 to 130/ 64 mmHg in case 3, and the effect continued for almost 5 hours. Plasma renin activity increased, while plasma aldosterone decreased. In response to long-term oral administration of SQ 14225 (75~150 mg/day), urinary sodium excretion increased in case 1 and 2, but serum potassium showed no remarkable change. As unexpected side effects of SQ 14225, case 2 showed orthostatic hypotension and case 3 taste disturbance.