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ESANSİYEL HİPERTANSİF HASTALARDA KAPTOPRİL TESTİNİN ÖNCEDEN BELİRLEYİCİLİĞİ

THE PREDICTIVE VALUE OF CAPTOPRIL TEST IN PATIENTS WITH ESSENTIAL HYPERTENSION

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Abstract (2. Language): 
The purpose of this study was to compare the predictive value of the captopril test Thirty patients who remained hypertensive with mild or moderate hypertension after 2-3 weeks of low sodium diet were underwent to the captopril test. Then patients were given 10 mg/day fosinopril. Positive result of the captopril test was seen in 21(70%) patients. In this subgroup, 20(95.2%) patients revealed normal blood pressure and only one (4.8%) patient remained hypertensive. Seven (77.7%) patients from the test negative subgroup, respond to the chronic fosinopril therapy and only two (22.3%) patients remained hypertensive. Consequently, 27(90%) patients were normotensive and only three (10%) patients remained hypertensive. The predictive power of the captopril test was estimated to be 22.3% in the negative subgroup and 95% in the positive subgroup. Consequently, any effect of the captopril test upon the therapy was not found (^=2.134, p=0.207). In conclusion, in mild and moderate hypertensive patients, if dietery sodium restriction fails to normalize the blood pressure, ACE-inhibitors can be started without paying any attention to the captopril test results.
Abstract (Original Language): 
Kaptopril testinin (KT) esansiyel hipertansiyonun ACE inhibitörleriyle tedavisindeki yeri kesin değildir. Bu nedenle çalışmamızın amacı tuz kısıtlamasına rağmen hafif/orta derecede hipertansiyonu olan hastalarda kaptopril testinin önceden belirleyiciliğini saptamaktı. Tuzsuz diyet uygulandıktan sonra hafif ve orta derecede hipertansiyonu olan 30 esansiyel hipertansif hastaya kaptopril testi yapıldı. Cevabına bakılmaksızın tüm hastalara 10 mgfosinopril verilip, ilk 10 gün hastanede yatırılarak her gün tansiyonları ölçüldü. Takip eden üç hafta boyunca her hafta tansiyonları tek ölçümle civalı sfıgmomanometreyle hastanede ölçüldü. KT'ne cevap verenler 21(%70) iken, bunlardan tedaviye cevap verenler 20 (%95.2) idi, önceden belirleyicilik ise %95 olduğu tespit edildi; KT'ne cevap vermeyenler dokuz (%30) iken, tedaviye cevap verenlerin sayısı yedi (%77.7) oldu, önceden belirleyicilik ise %22.3 idi. Tedaviden yarar görenlerin sayısı toplam 27(%90) idi. Sonuç olarak KT'nin yapılması tedavi üzerinde anlamlı bir etki oluşturmadı (^=2.134, p=0.207). Hafif ve orta hipertansif olgularda, tuz kısıtlaması ardından, önemli bir kontrendikasyon yoksa, kaptopril testi neticesine bakılmaksızın, ACE-inhibitörlerine başlanmalıdır.
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REFERENCES

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