PURPOSE: Sustained (late-phase) @entity2792 is associated with lower plasma @entity3449 activity than is the early phase. It is not clear to what extent this reduced plasma @entity3449 activity reflects diminished influence of the @entity3449 -angiotensin system. It also is not clear whether this change in the character of the disease influences the effectiveness of surgical removal of the @entity2791 in reversing @entity101 . Using an animal model of sustained (> or =10 weeks after renal artery clipping) two-kidney, one-clip @entity2792 , we hypothesized that the magnitude of the depressor response to selective @entity1808 receptor blockade with @entity9886 would reflect the influence of the @entity3449 -angiotensin system on @entity101 and enable us to predict the depressor response to subsequent surgical removal of the clip. METHODS: The left renal arteries of 20 male @entity35 weighing 150 to 200 gm were fitted with a @entity575 clip (0.23 mm internal diameter). Systolic blood pressure was measured by means of tail-cuff plethysmography for 10 weeks. @entity35 were then given @entity9886 orally (30 mg/kg a day) for 1 week while blood pressure was monitored. After an additional week to allow recovery, 13 @entity35 underwent surgical unclipping, and seven underwent sham repair. Blood pressure again was monitored over the final week. RESULTS: All two-kidney one-clip @entity35 had @entity101 10 weeks after clipping (mean systolic blood pressure 206 +/- 10 mm Hg). @entity9886 decreased systolic blood pressure by 36 +/- 6 mm Hg. The response was variable, ranging from 3 to 66 mm Hg, and overall blood pressure did not normalize (170 +/- 8 mm Hg). Subsequent surgical unclipping decreased systolic blood pressure by 46 +/- 9 mm Hg. Again the response was variable, ranging from 10 to 99 mm Hg, although overall blood pressure did not normalize (164 +/- 7 mm Hg). The decrease in blood pressure after unclipping showed a high correlation with the blood pressure decrease after @entity9886 administration (r = 0.861, p < 0.001). Resting plasma @entity3449 activity (before intervention) was 16 +/- 4 ng angiotensin I per milliliter per hour and was not predictive of the response to either @entity9886 or surgical unclipping. The @entity35 subjected to sham operations had no statistically significant changes in blood pressure. Histologic evaluation showed patent renal arteries without appreciable @entity850 or intimal @entity1373 after removal of the clips. CONCLUSIONS: In sustained two-kidney, one-clip @entity2792 , the depressor response to @entity1808 receptor blockade is attenuated, suggesting that late-phase @entity101 becomes increasingly @entity1808 -independent. In our model, the extent to which sustained @entity2792 becomes refractory to 7 days of @entity1808 blockade is highly predictive of the ultimate outcome of surgical repair of @entity2791 .

Response to angiotensin inhibition in @entity35 with sustained XXXX correlates with response to removing @entity2791 .

@entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity575 :: ('MESH:D012834', 'Chemical') :: ['silver'] @entity1373 :: ('MESH:D006965', 'Disease') :: ['hyperplasia'] @entity1808 :: ('24179(Tax:10116)', 'Gene') :: ['angiotensin II'] @entity2792 :: ('MESH:D006978', 'Disease') :: ['renovascular hypertension'] @entity2791 :: ('MESH:D012078', 'Disease') :: ['renal artery stenosis'] @entity3449 :: ('24715(Tax:10116)', 'Gene') :: ['renin'] @entity9886 :: ('MESH:D019808', 'Chemical') :: ['losartan', 'Losartan'] @entity35 :: ('10116', 'Species') :: ['Sprague-Dawley rats', 'Rats', 'rats'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis']
@entity2792 :: (MESH:D006978,Disease) :: ['renovascular hypertension']
