Fosinopril led to a greater improvement in regulatory adaptive status compared to zofenopril (69.0% vs 41.1%) in hypertensive patients with heart failure with preserved ejection fraction.
RCT (n=67)
Does fosinopril improve regulatory adaptive status more than zofenopril in hypertensive patients with HFpEF?
In hypertensive patients with HFpEF, fosinopril may provide greater improvements in regulatory adaptive status and exercise tolerance compared to zofenopril.
Absolute Event Rate: 69% vs 41.1%
p-value: p=<0.01
Objective. To evaluate the impact of fosinopril versus zofenopril on the regulatory adaptive status (RAS) in hypertensive patients with chronic heart failure (CHF) with preserved left ventricular (LV) ejection fraction (EF). Design and methods. The study inclded 67 hospitalized patients with hypertension (HTN) and CHF I–II NYHA functional classes with LV EF ≥ 50 %, who were randomized into two groups for treatment with fosinopril (13,8 ± 4,1 mg/day, n = 32) or zofenopril (17,9 ± 5,9 mg/day, n = 35). All patients additionally received nebivolol (7,1 ± 1,9 and 6,9 ± 1,8 mg/day), and if needed, atorvastatin and acetylsalicylic acid were prescribed. At baseline and after 24 weeks, we performed quantitative assessment of RAS-regulatory-adaptive capabilities (by cardio-respiratory coupling test), echocardiography, treadmill test, six-minute walking test, assessment of the N-terminal brain natriuretic pro-peptide level in blood plasma, subjective evaluation of quality of life (QL). Results. Fosinopril versus zofenopril led to a greater improvement of RAS (by 69,0%, p < 0,01 versus 41,1%, p < 0,01) and to a higher increase in tolerance to physical activity: longer distance in a six-minute walk test (by 28,1 %, p < 0,05 versus 25,9 %, p < 0,05), improvement in functional class of CHF (from II to I in 56 % of patients, in 25 % CHF was not registered versus change from II to I in 42 % of patients, and no CHF in 14 %). In both groups, cardiac diastolic function improved (decreased VE/Ve by 39,5%, p < 0,01 and 37,8%, p < 0,01), neurohumoral hyperactivity reduced (NT-proBNP decreased by 40,6 %, p < 0,01 and 39,4 %, p < 0,01), and subjective QL increased (decrease in the amount of negative points by 69,3%, p < 0,01, and 64,9 %, p < 0,01). Conclusions . In HTN patients with CHF with preserved LV EF, fosinopril versus zofenopril may be preferable due to a greater impact on regulatory and adaptive capabilities.
Трегубов et al. (Fri,) conducted a rct in Hypertension and chronic heart failure with preserved left ventricular ejection fraction (n=67). Fosinopril vs. Zofenopril (17.9 ± 5.9 mg/day) was evaluated on Improvement of regulatory adaptive status (RAS) (p=<0.01). Fosinopril led to a greater improvement in regulatory adaptive status compared to zofenopril (69.0% vs 41.1%) in hypertensive patients with heart failure with preserved ejection fraction.