title: A randomized double-blind placebo-controlled trial to increase feasibility of dobutamine stress echocardiography in patients with hypertension.
abstract: OBJECTIVE
  To increase dobutamine stress echocardiography feasibility in patients with uncontrolled hypertension, we studied 729 consecutive patients referred for ischemia assessment.
  
  
  METHODS
  Patients with blood pressure (BP) levels above 160/110 mm Hg were randomized to sublingual placebo or captopril (25 mg), and dobutamine stress echocardiography undertaken if BP decreased below 160/110 mm Hg after 15 minutes.
  
  
  RESULTS
  Of 149 patients (20%) with high BP levels, 104 (63 +/- 11 years, 51 male) were randomized. Baseline BP levels were similar for captopril (178 +/- 15/103 +/- 15 mm Hg) and placebo (181 +/-17/103 +/- 15 mm Hg) groups. After intervention, 15 patients from captopril and 17 from placebo group had decreased BP (11% and 12% for systolic and 13% and 13% for diastolic BP, respectively). Five patients from placebo group (P = .007) had to prematurely terminate the test because of hypertension (BP > 220/120 mm Hg). Feasibility was similar for captopril and placebo groups (35% vs 25%, respectively, P = not significant).
  
  
  CONCLUSIONS
  Although both captopril and placebo are effective in increasing dobutamine stress echocardiography feasibility in patients with uncontrolled BP, test interruption because of hypertension is less likely to occur after captopril administration.
authors: Heart Institute (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. claratude@yahoo.com
authors: Ana Clara Tude
authors: AC
authors: Rodrigues
authors: Viviane Tiemi
authors: VT
authors: Hotta
authors: Francisco Maciel de Oliveira
authors: FM
authors: Borges Neto
authors: Joao Manoel Theotonio
authors: JM
authors: dos Santos
authors: Maria Luciana Hannouche
authors: ML
authors: Trindade
authors: Wilson
authors: W
authors: Mathias
mesh_terms: D000959:Antihypertensive Agents; D002216:Captopril; D004280:Dobutamine; D004311:Double-Blind Method; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015990:Placebo Effect; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D004280:Dobutamine; D002216:Captopril