[The clinical use of captopril in the diagnosis and treatment of primary aldosteronism].

The responses of blood pressure (BP) and renin-angiotensin-aldosterone system to captopril were studied in 9 patients with primary aldosteronism (PA) including 7 cases of idiopathic hyperaldosteronism (IHA) and 2 cases of aldosterone-producing adrenal adenoma (APA). 2 hrs after the administration of 25 mg captopril, plasma renin activity (PRA) increased significantly, plasma angiotensin II (PAII) and aldosterone concentration (PAC) declined remarkably, BP reduced to normal in 4 of 6 patients in IHA, no changes in PRA, PAII and PAC in patients with APA but significant BP drop in patient with APA. The results suggest sensitivity of the hyperplastic adrenal gland to AII is heightened. It is helpful in the diagnosis of PA, BP can be well controlled with combined captopril (75 mg/d) and small dose of spironolactone (60 mg/d) in most of the IHA.