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320 SECTION IV Drugs with Important Actions on Smooth Muscle

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C ASE STUD Y ANSWER

Enalapril lowers blood pressure by blocking the conver- aliskiren, or an ANG II receptor antagonist, eg, valsartan,
sion of angiotensin I to angiotensin II (ANG II). Since instead of an angiotensin-converting enzyme inhibitor, to
converting enzyme also inactivates bradykinin, enalapril block the renin-angiotensin system. A β-adrenoceptor-
increases bradykinin levels, and this is responsible for blocking drug might also be tried since, in addition
adverse side effects such as cough and angioedema. This to their cardiac action, these drugs can inhibit renin
problem might be avoided by using a renin inhibitor, eg, secretion.