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From: ironjustice on 20 Oct 2007 02:13
Hmmm ..

ACE inhibitor effective for high-altitude blood disorder

22 February 2002
Lancet 2002; 359: 663-666
ACE inhibitors may reduce cardiovascular complications of a blood
disorder affecting up to 15% of people living at high altitudes,
claims a European team of researchers.

People suffering from altitude polycythemia produce increased levels
of the hormone erythropoitin at high altitudes, which may lead to an
excess of erythrocytes, a high frequency of persistent proteinuria,
chronic renal dysfunction, hypertension, and other cardiovascular
complications.

Previous research has already demonstrated the efficacy of ACE
inhibitors in another form of polycythemia, through inhibition of the
renin-angiotensin system. Therefore, Raul Plata (Renal Disease
Project, La Paz, Bolivia) and colleagues investigated ACE inhibitor
treatment on people with altitude polycythemia using a small,
randomized trial.

All 26 participants had been born at 3200-4000m and had lived in La
Paz, at 3600m, for at least a year.

Thirteen participants were assigned to 5mg/day enalapril, and thirteen
to no treatment for two years. Urine protein excretion, blood
pressure, body weight, packed cell volume, hemoglobin concentration,
proteinuria, and renal function measurements were taken after 12 and
24 months and compared with those at baseline.

The researchers found that packed cell volume, hemoglobin
concentration, and 24-hour protein urine excretion decreased
significantly in the treatment group, but not in controls.

Systolic and diastolic blood pressure decreased slightly, but not
significantly, in those treated with enalapril, compared with
controls.

'Reductions in both packed cell volume and proteinuria should have an
additive effect in decreasing the cardiovascular and renal
complications of altitude polycythemia, and, in the long term, should
substantially reduce morbidity and mortality,' say the researchers.

-----------------------------------------------

Angiotensin converting enzyme inhibitor-induced angioedema: a report
of two cases
Journal Pediatric Nephrology

Authors
F. K. Assadi, H. E. Wang2, S. Lawless2, C. P. McKay1, L. Hopp1, D.
Fattori1
1Department of Pediatrics, Division of Nephrology, Alfred I. duPont
Hospital for Children, Wilmington, Delaware, USA
2Department of Pediatrics, Division of Anesthesia/Critical Care,
Jefferson Medical College, Philadelphia, Pennsylvania, USA
3Division of Nephrology, A.I. duPont Hospital for Children, 1600
Rockland Road, Wilmington, DE 19899, USA e-mail: fassadi(a)nemours.org
Tel.: +1-302-6514114, Fax: +1-302-6514547


Abstract

Angioedema is a rare but potentially fatal side effect of angiotensin
converting enzyme (ACE) inhibitors. We report for the first time, two
children with systemic lupus erythematosus who developed acute
angioedema after the long-term use of enalapril. Prompt recognition
and appropriate management of ACE-induced angioedema prevented life-
threatening complications. This report highlights the potential risks
of angioedema associated with the use of ACE inhibitors in children.
Patients should be advised to seek medical treatment immediately if
they experience swelling of the face, neck, or tongue, and especially
if they have trouble breathing, speaking, or swallowing.
Publisher Springer Berlin / Heidelberg
ISSN 0931-041X (Print) 1432-198X (Online)
Issue Volume 13, Number 9 / November, 1999
Category Original Article
DOI 10.1007/s004670050727
Pages 917-919
Subject Collection Medicine
SpringerLink Date Thursday, February 19, 2004

Keywords
Key words Angioedema · Angiotensin converting enzyme inhibitor ·
Enalapril

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