Reversal of diuretic-induced secondary hyperaldosteronism and hypokalemia by enalapril (MK-421): a new angiotensin-converting enzyme inhibitor.

Abstract

The study reported here prospectively evaluated the prevention of diuretic-induced secondary hyperaldosteronism and hypokalemia by a converting enzyme inhibitor, enalapril (MK 421). Eighteen normal subjects were randomized into three groups: (1) a HCTZ group (hydrochlorothiazide (HCTZ) 50 mg/day); (2) a MK-421 group (MK-421 10 mg/day); and (3) a HCTZ + MK-421 group [HCTZ 50 mg/day plus MK-421 10 mg/day]. Following a five-day control and a 28-day treatment period, the HCTZ group demonstrated an attenuated but persistent secondary hyperaldosteronism and hypokalemia, the MK-421 group manifested a gradual decline in aldosterone secretion, and the HCTZ + MK-421 group had a delayed but effective correction of secondary hyperaldosteronism and hypokalemia at 28 days but not before. In conclusion, MK-421 reversed diuretic-induced secondary hyperaldosteronism and hypokalemia after 28 days of hydrochlorothiazide therapy. Therefore, converting enzyme inhibitors, such as enalapril, provide useful adjunctive therapy in diuretic-treated patients, but potassium supplementation may be required before the start of four weeks of combined therapy.

• Authors: G T Griffing, B H Sindler, S A Aurecchia, J C Melby
• Journal: Metabolism: clinical and experimental (Metabolism) Vol. 32 Issue 7 Pg. 711-6 (Jul 1983) ISSN: 0026-0495 [Print] United States
• PMID: 6306388 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Dipeptides
• Diuretics
• Electrolytes
• Hydrochlorothiazide
• Enalapril
• Renin

Topics

• Angiotensin-Converting Enzyme Inhibitors
• Dipeptides (therapeutic use)
• Diuretics (adverse effects, antagonists & inhibitors)
• Electrolytes (metabolism)
• Enalapril
• Humans
• Hydrochlorothiazide (antagonists & inhibitors)
• Hyperaldosteronism (chemically induced, prevention & control)
• Hypokalemia (chemically induced, prevention & control)
• Random Allocation
• Renin (blood)