IRENE GAVRAS, M.D.; HARALAMBOS GAVRAS, M.D.
To the editor: Inhibition of the angiotensin-converting enzyme by captopril is an established treatment for hypertension (1) and is increasingly popular as an adjunct treatment for congestive cardiac failure (2). Yet the possibility of an unpredictable and potentially adverse reaction effectively deters the more widespread use of angiotension-converting enzyme inhibition.
Most investigators believe that the side effects of captopril are due to the mercapto group in its molecule identical to other heavy metal antagonists (such as penicillamine) with similar molecular structure but different pharmacologic actions. However, the inhibition of the angiotensin-converting enzyme could account for adverse reactions.
Enalapril maleate (MK-421;
GAVRAS I, GAVRAS H. Captopril and Enalapril. Ann Intern Med. ;98:556–557. doi: 10.7326/0003-4819-98-4-556_2
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Published: Ann Intern Med. 1983;98(4):556-557.
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