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Partial angiotensin-converting enzyme inhibition during acute orthostatic stress in persons with tetraplegia.
- Source :
-
The journal of spinal cord medicine [J Spinal Cord Med] 2005; Vol. 28 (2), pp. 103-8. - Publication Year :
- 2005
-
Abstract
- Introduction: Individuals with tetraplegia rely on the renin-angiotensin system for orthostatic blood pressure control.<br />Objectives: To determine the effect of partial angiotensin-converting enzyme (ACE) inhibition on heart rate (HR), active plasma renin (PR), and mean arterial blood pressure (MAP) during acute orthostasis in subjects with tetraplegia (n = 7) and nondisabled persons (n = 8).<br />Methods: Subjects were instructed to avoid caffeine and alcohol for 24 hours before testing and to report to the laboratory between 10 AM and 1 PM. Progressive head-up tilt (15 degrees, 25 degrees, 35 degrees, and 45 degrees) was performed on 2 separate days; Day 1: without ACE inhibition; Day 2: after intravenous (IV) infusion of enalaprilat (0.625 mg).<br />Results: HR was reduced during orthostasis in the tetraplegia compared with the nondisabled group (P < 0.0001), and was unaffected by ACE inhibition in either group. PR was not increased with orthostasis in either group, but was increased after ACE inhibition in both groups (P < 0.001). MAP was not affected by orthostasis in either group, but was reduced with ACE inhibition in both groups (P < 0.01). In the tetraplegia group, MAP was initially reduced after ACE inhibition, but was maintained thereafter with increasing angles of tilt, and no subject complained of symptomatic orthostatic hypotension.<br />Conclusion: Subjects with tetraplegia were tolerant of an acute bout of orthostatic stress after partial ACE inhibition. This may have clinical relevance because of the increased prevalence of type 2 diabetes mellitus in this population and the use of ACE inhibitors for the treatment of progressive renal and cardiovascular disease.
- Subjects :
- Adult
Cervical Vertebrae
Humans
Middle Aged
Quadriplegia etiology
Spinal Cord Injuries complications
Spinal Cord Injuries physiopathology
Tilt-Table Test
Angiotensin-Converting Enzyme Inhibitors pharmacology
Blood Pressure drug effects
Dizziness physiopathology
Enalaprilat pharmacology
Quadriplegia physiopathology
Renin-Angiotensin System drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1079-0268
- Volume :
- 28
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The journal of spinal cord medicine
- Publication Type :
- Academic Journal
- Accession number :
- 15889697
- Full Text :
- https://doi.org/10.1080/10790268.2005.11753806