Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors.
OBJECTIVE
To compare blood pressure response to dynamic exercise in hypertensive patients taking trandolapril or captopril.


METHODS
We carried out a prospective, randomized, blinded study with 40 patients with primary hypertension and no other associated disease. The patients were divided into 2 groups (n=20), paired by age, sex, race, and body mass index, and underwent 2 symptom-limited exercise tests on a treadmill before and after 30 days of treatment with captopril (75 to 150 mg/day) or trandolapril (2 to 4 mg/day).


RESULTS
The groups were similar prior to treatment (p<0.05), and both drugs reduced blood pressure at rest (p<0.001). During treatment, trandolapril caused a greater increase in functional capacity (+31%) than captopril (+17%; p=0.01) did, and provided better blood pressure control during exercise, observed as a reduction in the variation of systolic blood pressure/MET (trandolapril: 10.7 1.9 mmHg/U vs 7.4 1.2 mmHg/U, p=0.02; captopril: 9.1 1.4 mmHg/U vs 11.4 2.5 mmHg/U, p=0.35), a reduction in peak diastolic blood pressure (trandolapril: 116.8 3.1 mmHg vs 108.1 2.5 mmHg, p=0.003; captopril: 118.2 3.1 mmHg vs 115.8 3.3 mmHg, p=0.35), and a reduction in the interruption of the tests due to excessive elevation in blood pressure (trandolapril: 50% vs 15%, p=0.009; captopril: 50% vs 45%, p=0.32).


CONCLUSIONS
Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.
Carreira
Maria Angela M Q
MA
Universidade Federal Fluminense, Niterói, RJ, Brazil. carreira@cardiol.br
Tavares
Leandro R
LR
Leite
Rafaela F
RF
Ribeiro
Jamila C
JC
Santos
Antônio C
AC
Pereira
Karla G
KG
Velarde
Guilhermo C
GC
Nóbrega
Antonio Claudio L
AC
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D002216:Captopril / Q000627:therapeutic use*; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D007211:Indoles; C052035:trandolapril; D002216:Captopril