Angiotensin converting enzyme inhibitors when used for a long time in patients with hypertension, cause:
Ans. (B) Reduction in filtration fraction(Ref: Goodman & Gilman 11/e p804)*Angiotensin II shifts the renal pressure natriuresis curve to right and helps to adjust the sodium level of the body according to dietary intake of sodium (more excretion with more intake and less excretion with less consumption). ACE inhibitors block this action of angiotensin II and cause leftward shift of renal pressure natriuresis curve, so that if sodium intake is decreased much more natriuresis can occur.*ACE inhibitors increase renal blood flow without increasing GFR and thus result in reduction of filtration fraction*ACE inhibitors do not significantly increase heart rate.*There are variable effect on various vascular beds with ACE inhibitors, these can dilate large arteries.
Rightward shift in renal pressure-natriuresis curve
Reduction in filtration fraction
Significant increase in heart rate
No change in compliance of large arteries
C.V.S