Key result
Low dose perindopril caused changes in blood pressure similar to placebo, whereas captopril and enalapril produced significant falls in blood pressure in elderly patients with heart failure.
Why the study?
Do low-dose angiotensin converting enzyme inhibitors (captopril, enalapril, perindopril) differ in their first-dose blood pressure and heart rate responses compared to placebo in elderly patients with stable chronic heart failure?
Population
n=48 elderly patients with symptomatic but stable chronic heart failure admitted for supervised diuretic…
Comparison
Daily oral dose of captopril, enalapril, or… vs Daily oral dose of placebo.
Design
RCT, randomised, parallel group, Double blind
Follow-up
acute response (up to 10 hours)
Authors
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May favor low-dose perindopril initiation in elderly HF to limit first-dose hypotension; confirms differential acute BP effects among ACE inhibitors.
RCT (n=48)
Double blind
randomised
No
Do low-dose angiotensin converting enzyme inhibitors (captopril, enalapril, perindopril) differ in their first-dose blood pressure and heart rate responses compared to placebo in elderly patients with stable chronic heart failure?
Low-dose perindopril is less likely to cause acute first-dose hypotension compared to captopril and enalapril in elderly patients with stable chronic heart failure.
MacFadyen et al. (1991) conducted an RCT in stable chronic heart failure (n=48). captopril, enalapril, or perindopril vs. placebo was evaluated on Blood pressure and heart rate responses, drug concentration, and plasma renin and ACE activities. Low dose perindopril caused changes in blood pressure similar to placebo, whereas captopril and enalapril produced significant falls in blood pressure in elderly patients with heart failure.
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