The effects of ACE inhibitors on exercise capacity in the treatment of congestive heart failure.
In a double-blind, placebo-controlled, randomized, multicenter study, 225 patients with mild to moderate congestive heart failure (CHF) due to arterial hypertension and ischemic heart disease received quinapril, a new non-sulfhydryl angiotensin-converting enzyme (ACE) inhibitor, in addition to maintenance therapy with digitalis and/or diuretics. The patients were randomized into four groups: (a) placebo; (b) quinapril, 5 mg twice daily (b.i.d.); (c) quinapril, 10 mg b.i.d.; and (d) quinapril, 20 mg b.i.d. All four groups were treated for 12 weeks. Patients receiving quinapril showed significant improvement in exercise time and NYHA functional class compared with those receiving placebo. A subset of 26 patients who received neither digitalis nor diuretics showed the same beneficial response after quinapril administration that was shown by patients who received maintenance therapy. After the double-blind trial, 189 patients entered a 1-year, open-label study in which the quinapril dosage could be titrated to a maximum of 40 mg/day (20 mg b.i.d.). The beneficial effect of quinapril was maintained over 12 months even when most patients received lower doses than in the double-blind trial.
Medizinische Universitätsklinik, Würzburg, F.R.G.
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Riegger
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D015444:Exercise; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007546:Isoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D000077583:Quinapril; D016032:Randomized Controlled Trials as Topic; D044005:Tetrahydroisoquinolines
D000806:Angiotensin-Converting Enzyme Inhibitors; D007546:Isoquinolines; D044005:Tetrahydroisoquinolines; D000077583:Quinapril