RT Book, Section A1 Reid, Ian A. A2 Katzung, Bertram G. SR Print(0) ID 1148435280 T1 Vasoactive Peptides T2 Basic & Clinical Pharmacology, 14e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781259641152 LK accessmedicine.mhmedical.com/content.aspx?aid=1148435280 RD 2024/10/04 AB CASE STUDYDuring a routine check and on two follow-up visits, a 45-year-old man was found to have high blood pressure (160–165/95–100 mm Hg). His physician initially prescribed hydrochlorothiazide, a diuretic commonly used to treat hypertension. His blood pressure was reduced by hydrochlorothiazide but remained at a hypertensive level (145/95 mm Hg), and he was referred to the university hypertension clinic. Because the patient had elevated plasma renin activity and aldosterone concentration, hydrochlorothiazide was replaced with enalapril, an angiotensin-converting enzyme inhibitor. Enalapril lowered his blood pressure to almost normotensive levels. However, after several weeks on enalapril, the patient returned complaining of a persistent cough. In addition, some signs of angioedema were detected. How does enalapril lower blood pressure? Why does it occasionally cause coughing and angioedema? What other drugs could be used to inhibit the renin-angiotensin system and decrease blood pressure, without the adverse effects of enalapril?