title: [Captopril versus digoxin in the treatment of mild to moderately severe heart failure].
abstract: In a randomized and double-blind study of 116 patients with chronic heart failure (NYHA classes II or III) the effectiveness of captopril + hydrochlorothiazide (HCT) (group 1) and of digoxin + HCT (group 2) were compared. Treatment was effected for a 12-month period with a combination of 50 mg captopril (twice 25 mg daily, oral) and HCT, or 0.2 mg digoxin (twice 0.1 mg daily, oral) and HCT. In a pretreatment phase over 3-4 weeks the patients of group 1 were given an average HCT dose of 37.7 mg daily, whereas those of group 2 received 34.9 mg per day. At the end of the 12-month treatment period the patients in the captopril/HCT group had improved significantly more--by the criteria of echocardiographic intracardiac diameters, exercise tolerance and NYHA class--than those in the digoxin/HCT group. Change by a mean of one NYHA class had occurred in 61 patients (51.8%) of group 1 and in 47 (40.7%) of group 2 (P les than 0.01). These findings suggest that treatment of patients with mild to moderately severe chronic heart failure in sinus rhythm best be initiated with an angiotensin-converting enzyme inhibitor together with a diuretic rather than a digitalis-diuretic combination.
authors.affiliation: Medizinische Universitätsklinik, Innere Medizin-Kardiologie, Bonn.
authors.forename: I
authors.initials: I
authors.lastname: Heck
authors.forename: H M
authors.initials: HM
authors.lastname: Müller
authors.forename: H
authors.initials: H
authors.lastname: Esser
authors.forename: B
authors.initials: B
authors.lastname: Lüderitz
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004077:Digoxin / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects
chemical_list: D006852:Hydrochlorothiazide; D004077:Digoxin; D002216:Captopril
vernacular_title: Captopril versus Digoxin in der Behandlung der leichten bis mittelschweren Herzinsuffizienz.