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Nephrol Dial Transplant (2000) 15: 2-5
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Captopril prevention project—what shall we do about captopril and the risk of stroke?

Albert Fournier, André Pruna, Najeh El Esper, Raïfah Makdassi, Roxana Oprisiu, Pierre-François Westeel, Hakim Mazouz and Jean-Michel Achard

Service de Néphrologie, Médecine Interne, CHU d'Amiens, France

Correspondence and offprint requests to: Albert Fournier, Service de Néphrologie, Médecine Interne, CHU d'Amiens, Hôpital Sud, Av René Laënnec-Salouel, F-80054 Amiens Cedex, France.

Introduction

Angiotensin-converting enzyme inhibitors (ACEI) are widely prescribed. In the US their prescription rate for hypertension places them third, behind calcium antagonists and diuretics but in front of beta blockers [1]. This success, in spite of the cough problem, is due to aggressive marketing based around putative cardioprotective and nephroprotective effects. The cardioprotective effect has been demonstrated by the reduction of overall cardiac morbidity and mortality in patients with congestive heart failure or post-infarction left ventricular dysfunction [2]. The nephroprotective effect is claimed for diabetic [3] and non-diabetic [4] renal patients on the basis of greater reduction of proteinuria and greater delay in the progression to end-stage renal failure when compared to conventional treatment, although blood-pressure-independent protection has not been convincingly shown [4]. Primary cardiovascular protection in hypertensive patients had, however, not been specifically tested. Therefore the results of the Captopril . . . [Full Text of this Article]

Results of CAPPP

How reliable are the results of CAPPP?

Explanation for the brain ischaemia protective effect of angiotensin II

Proposal to evaluate AT1 receptor blockade for the prevention of strokes

Practical consequences for antihypertensive drug prescriptions

References


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