Captopril significantly increased the proportion of patients achieving >85% reduction in ventricular ectopic activity per day compared to placebo (57% vs 8%, P=0.004).
RCT (n=27)
Double-blind
randomized
Does captopril reduce ventricular ectopic activity in patients with mild-to-moderate hypertension and increased left ventricular mass index?
In patients with mild-to-moderate hypertension and left ventricular hypertrophy, treatment with captopril reduces left ventricular mass and significantly decreases ventricular ectopic activity.
Absolute Event Rate: 57% vs 8%
p-value: p=.004
To assess the effects of left ventricular mass reduction on the prevalence of ventricular ectopic activity, we conducted a double-blind, placebo-controlled trial measuring ambulatory 48 h premature ventricular depolarizations in 27 patients with mild-to-moderate hypertension and an increased left ventricular mass index. Data was obtained at baseline and 6 +/- 2 months after randomization to either 25 mg captopril or placebo twice a day. Patients on captopril attained reduction in blood pressure from 167 +/- 11/103 +/- 6 to 136 +/- 10/85 +/- 5 mm Hg (P = .001), left ventricular mass index regression from 149 +/- 17 to 96 +/- 23 g/m2 (P = .001), and ventricular ectopic activity reduction from 413 +/- 172 to 77 +/- 27 ventricular extrasystoles/day (P = .001). Patients on placebo had no significant change in blood pressure (from 162 +/- 11/101 +/- 6 at baseline to 160 +/- 8/100 +/- 8 mm Hg after 6 months; P = NS). In the placebo group left ventricular mass index increased from 155 +/- 40 to 182 +/- 51 g/m2 (P = .01), and ventricular ectopic activity decreased from 634 +/- 293 to 562 +/- 260 ventricular extrasystoles/day (P = NS). Eight out of 14 patients on captopril (57%) and 1 out of 13 patients on placebo (8%) achieved reduction > 85% in ventricular ectopic activity per day (P = .004). Using multivariate logistic regression analysis, left ventricular mass index regression and reduction in systolic blood pressure were the most important correlates for this effect.(ABSTRACT TRUNCATED AT 250 WORDS)
González-Fernández et al. (Thu,) conducted a rct in Mild-to-moderate hypertension and increased left ventricular mass index (n=27). Captopril vs. Placebo was evaluated on Reduction > 85% in ventricular ectopic activity per day (p=.004). Captopril significantly increased the proportion of patients achieving >85% reduction in ventricular ectopic activity per day compared to placebo (57% vs 8%, P=0.004).