title: Blood pressure response to the first 36 hours of heart failure therapy with perindopril versus captopril. French General Hospitals National College of Cardiologists.
abstract: An open randomized hospital study conducted in 169 centers in France compared the blood pressure response to the first 36 h of treatment with perindopril (PER), 2 mg once daily, with that to captopril (CAP), 6.25 mg t.i.d., in 725 patients (mean age, 70 years; men, 67%) with echocardiographic left ventricular systolic dysfunction (fractional shortening, < or = 28%) due to ischemia (56.7%) or hypertension (34.5%) and a systolic blood pressure (SBP) > or = 120 mm Hg. Each dose of CAP induced a sharp and rapid decrease in blood pressure (maximum, 1.5-2 h); with PER, the decrease was gradual (maximum, 6 h) and variation was less marked. However, at 36 h, the decrease in blood pressure versus baseline was similar on both treatments. Over the 36-h period, there were 22 (3%) dropouts due to marked orthostatic hypotension (SBP, <90 mm Hg), and they were fewer with PER than with CAP: 16 cases in the CAP group versus six in the PER group (p = 0.036). At 36 h, heart rate was lower with CAP than with PER: 75.2 versus 77.5 beats/min, respectively (p = 0.039). As initial therapy for stabilized left ventricular systolic dysfunction, the first dose of PER (2 mg) induced a significantly smaller decrease in blood pressure than the first dose of CAP (6.25 mg); dropouts due to orthostatic hypotension were also significantly fewer with PER than with CAP.
authors.affiliation: Service de Cardiologie, Centre Hospitalier, Saint-Germain-en-Laye, France.
authors.forename: R
authors.initials: R
authors.lastname: Haïat
authors.forename: O
authors.initials: O
authors.lastname: Piot
authors.forename: H
authors.initials: H
authors.lastname: Gallois
authors.forename: G
authors.initials: G
authors.lastname: Hanania
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D002216:Captopril / Q000494:pharmacology*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications; D007024:Hypotension, Orthostatic / Q000139:chemically induced; D007211:Indoles / Q000494:pharmacology*; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications; D010352:Patient Dropouts; D020913:Perindopril; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D007211:Indoles; D002216:Captopril; D020913:Perindopril