Reduction of Sympathetic Hyperactivity by Enalapril in Patients with Chronic Renal Failure

Patients with essential hypertension, 1 , 2 accelerated hypertension, 3 or chronic renal failure 4 have increased sympathetic activity, which contributes not only to their hypertension but also to atherogenesis and cardiac hypertrophy. 5 , 6 In patients with congestive heart failure, sympathetic overactivity is associated with a poor prognosis and an increased risk of cardiac arrhythmias and sudden death. 7 , 8 Angiotensin-converting–enzyme (ACE) inhibitors and calcium-channel blockers are widely used in all these conditions to lower blood pressure or improve cardiac function, but whether these two classes of drugs differ in their ability to control sympathetic overactivity is not known. ACE inhibition is accompanied by a . . .