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Hypertension in a Patient With Hypercalcemia: Captopril and Verapamil

Hypertension in a Patient With Hypercalcemia: Captopril and Verapamil Abstract • A 38-year-old woman with hypercalcemia, severe hypertension, and high renin levels was treated with the angiotensin-converting enzyme inhibitor captopril. This therapy, together with spironolactone, normalized blood pressure (BP), but even with three daily administrations of the converting enzyme inhibitor, intermittent rebound hypertension could not be avoided. The administration of only verapamil, an antagonist of calcium transport, did not induce BP control, but when verapamil therapy was combined with administration of captopril and spironolactone, BP could be normalized with only twice-daily administration of the converting enzyme inhibitor. Thus, high plasma calcium levels seem to sensitize the arterioles to the intermittent increase of angiotensin II levels that accompanies captopril therapy. (Arch Intern Med 1982;142:143-145) References 1. Rosenthal SR: Hypertension and hyperparathyroidism. Br Med J 1972;4:396-397.Crossref 2. Ferguson RK, Turini GA, Brunner HR, et al: A specific orally active inhibitor of angiotensin-converting enzyme in man. Lancet 1977;1:775-778.Crossref 3. Singh BN, Ellrodt G, Peter CT: Verapamil: A review of its pharmacological properties and therapeutic use. Drugs 1978;15:169-197.Crossref 4. Gavras H, Brunner HR, Turini GA, et al: Antihypertensive effect of the oral angiotensin-converting enzyme inhibitor SQ 14,225 in man. N Engl J Med 1978;298:991-995.Crossref 5. Middler S, Pak CYC, Murad F, et al: Thiazide diuretics and calcium metabolism. Metabolism 197322:139-146.Crossref 6. Potts JT Jr, Murray TM, Peacock M, et al: Parathyroid hormone: Sequence, synthesis, immunoassay studies. Am J Med 1971;50:639-649.Crossref 7. Purnell DC, Smith LH, Scholz DA, et al: Primary hyperparathyroidism: A prospective clinical study. Am J Med 1971;50:670-678.Crossref 8. Brunner HR, Gavras H, Waeber B, et al: Oral angiotensin-converting enzyme inhibitor in long-term treatment of hypertensive patients. Ann Intern Med 1979;90:19-23.Crossref 9. Waeber B, Brunner HR, Brunner DB, et al: Discrepancy between antihypertensive effect and angiotensin-converting enzyme inhibition by captopril. Hypertension 1980;2:236-242.Crossref 10. Godfraind T, Kaba A: Blockade or reversal of the contraction induced by calcium and adrenaline in depolarized arterial smooth muscle. Br J Pharmacol 1969;36:549-560.Crossref 11. Brinton GS, Jubiz W, Lagerquist LD: Hypertension in primary hyperparathyroidism: The role of the renin-angiotensin system. J Clin Endocrinol Metab 1975;41:1025-1029.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Hypertension in a Patient With Hypercalcemia: Captopril and Verapamil

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340140145024
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 38-year-old woman with hypercalcemia, severe hypertension, and high renin levels was treated with the angiotensin-converting enzyme inhibitor captopril. This therapy, together with spironolactone, normalized blood pressure (BP), but even with three daily administrations of the converting enzyme inhibitor, intermittent rebound hypertension could not be avoided. The administration of only verapamil, an antagonist of calcium transport, did not induce BP control, but when verapamil therapy was combined with administration of captopril and spironolactone, BP could be normalized with only twice-daily administration of the converting enzyme inhibitor. Thus, high plasma calcium levels seem to sensitize the arterioles to the intermittent increase of angiotensin II levels that accompanies captopril therapy. (Arch Intern Med 1982;142:143-145) References 1. Rosenthal SR: Hypertension and hyperparathyroidism. Br Med J 1972;4:396-397.Crossref 2. Ferguson RK, Turini GA, Brunner HR, et al: A specific orally active inhibitor of angiotensin-converting enzyme in man. Lancet 1977;1:775-778.Crossref 3. Singh BN, Ellrodt G, Peter CT: Verapamil: A review of its pharmacological properties and therapeutic use. Drugs 1978;15:169-197.Crossref 4. Gavras H, Brunner HR, Turini GA, et al: Antihypertensive effect of the oral angiotensin-converting enzyme inhibitor SQ 14,225 in man. N Engl J Med 1978;298:991-995.Crossref 5. Middler S, Pak CYC, Murad F, et al: Thiazide diuretics and calcium metabolism. Metabolism 197322:139-146.Crossref 6. Potts JT Jr, Murray TM, Peacock M, et al: Parathyroid hormone: Sequence, synthesis, immunoassay studies. Am J Med 1971;50:639-649.Crossref 7. Purnell DC, Smith LH, Scholz DA, et al: Primary hyperparathyroidism: A prospective clinical study. Am J Med 1971;50:670-678.Crossref 8. Brunner HR, Gavras H, Waeber B, et al: Oral angiotensin-converting enzyme inhibitor in long-term treatment of hypertensive patients. Ann Intern Med 1979;90:19-23.Crossref 9. Waeber B, Brunner HR, Brunner DB, et al: Discrepancy between antihypertensive effect and angiotensin-converting enzyme inhibition by captopril. Hypertension 1980;2:236-242.Crossref 10. Godfraind T, Kaba A: Blockade or reversal of the contraction induced by calcium and adrenaline in depolarized arterial smooth muscle. Br J Pharmacol 1969;36:549-560.Crossref 11. Brinton GS, Jubiz W, Lagerquist LD: Hypertension in primary hyperparathyroidism: The role of the renin-angiotensin system. J Clin Endocrinol Metab 1975;41:1025-1029.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1982

References