Abstract | OBJECTIVE: DESIGN: Double blind, randomised, placebo controlled, parallel group prospective study. SETTING: General hospital inpatient admissions for supervised diuretic withdrawal (24-48 hours) and the introduction of ACE inhibitor treatment. PATIENTS: 36 unselected elderly (aged 60-87 years) patients with symptomatic but stable chronic cardiac failure (New York Heart Association grades II-IV). ACE inhibitor started under double blind conditions with blood pressure monitoring. INTERVENTION: Patients were randomly allocated to receive intravenous placebo (saline), enalaprilat (1.5 mg over six hours) or perindoprilat (1 mg over six hours) by constant rate intravenous infusion (5 ml/hour). The protocol allowed for discontinuation of infusion if mean arterial blood pressure fell by 30% from the value before treatment. MAIN OUTCOME MEASURES: Blood pressure and heart rate responses, drug concentration, plasma renin, and ACE activities. RESULTS: The three groups had similar age, severity of heart failure, diuretic dose before treatment, plasma renin activity, and serum electrolyte state. All patients remained symptom free throughout the study. Infusions were only ended early with active treatment: 5/12 perindoprilat cases, (mean (SD) dose 0.88 (0.18) mg, and 5/12 enalaprilat cases (mean (SD) dose 1.2 (0.4) mg. Both active treatments lowered mean arterial pressure until discontinuation of infusion. Heart rate was not altered. Two patients (one perindoprilat, one enalaprilat) showed transient and symptom free renal impairment. CONCLUSIONS:
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Authors | R J MacFadyen, K R Lees, J L Reid |
Journal | British heart journal
(Br Heart J)
Vol. 69
Issue 4
Pg. 293-7
(Apr 1993)
ISSN: 0007-0769 [Print] England |
PMID | 8387806
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Angiotensin-Converting Enzyme Inhibitors
- Indoles
- perindoprilat
- Renin
- Enalaprilat
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Topics |
- Aged
- Aged, 80 and over
- Angiotensin-Converting Enzyme Inhibitors
(blood, therapeutic use)
- Blood Pressure
(drug effects)
- Double-Blind Method
- Enalaprilat
(blood, therapeutic use)
- Female
- Heart Failure
(blood, drug therapy)
- Heart Rate
(drug effects)
- Humans
- Indoles
(blood, therapeutic use)
- Male
- Middle Aged
- Prospective Studies
- Renin
(blood)
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