A randomized double-blind placebo-controlled trial to increase feasibility of dobutamine stress echocardiography in patients with hypertension.
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.
Rodrigues
Ana Clara Tude
AC
Heart Institute (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. claratude@yahoo.com
Hotta
Viviane Tiemi
VT
Borges Neto
Francisco Maciel de Oliveira
FM
dos Santos
Joao Manoel Theotonio
JM
Trindade
Maria Luciana Hannouche
ML
Mathias
Wilson
W
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
D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D004280:Dobutamine; D002216:Captopril