Comparison of captopril with enalapril in the treatment of heart failure : influence on hemodynamics and measures of renal function

• Published in: Cardiovascular drugs and therapy Vol. 6; no. 2; pp. 173 - 180
• Main Authors: OSTERZIEL, K. J, DIETZ, R, HARDER, K, KÜBLER, W
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01-04-1992
• Subjects: Biological and medical sciences; Captopril - therapeutic use; Cardiovascular system; Catecholamines - blood; Electrolytes - blood; Enalapril - therapeutic use; Female; Heart Failure - drug therapy; Hemodynamics - drug effects; Humans; Kidney - drug effects; Male; Medical sciences; Middle Aged; Miscellaneous; Pharmacology. Drug treatments; Human; Heart failure; Chemotherapy; Renal function; Treatment; Enzyme; Angiotensin converting enzyme; Enzyme inhibitor; Cardiovascular disease; Hemodynamics; Coronary heart disease; Comparative study
• ISSN: 0920-3206; 1573-7241
• DOI: 10.1007/BF00054567

Twenty-nine patients with severe heart failure (NYHA III) were randomly assigned to receive therapy with an angiotensin converting enzyme inhibitor (ACE inhibitor), either captopril or enalapril. The mean daily dosage of captopril was 56 +/- 5 mg and of enalapril 9.5 +/- 0.4 mg. After a mean of 8 +/- 1 days, the influence of both ACE inhibitors on hemodynamics and renal function was compared. The mean arterial pressure in the group treated with captopril (Group A) fell by 9 +/- 3 mmHg (p less than 0.01), and in the group treated with enalapril (Group B) it fell by 12 +/- 3 mmHg (p less than 0.001). The difference between the groups was not significant. Heart rate decreased in both groups; however, the change was significant (p less than 0.05) only in patients treated with enalapril (-11 +/- 3 bpm in Group B vs. -7 +/- 4 bpm in Group A). Stroke volume index increased by 6 +/- 3 ml/m2 in Group A (p less than 0.05) vs. 10 +/- 2 ml/m2 in Group B (p less than 0.01). The increase in stroke volume index was not significantly different between the two groups. Mean decreases in pulmonary artery and right atrial pressure were also comparable in both groups. Thus, hemodynamic improvements were similar during therapy with either captopril or enalapril. Serum sodium and potassium before therapy were 137 +/- 1 mmol/l and 4.1 +/- 0.1 mmol/l, respectively, in group A and 139 +/- 1 mmol/l and 4.0 +/- 0.1 mmol/l, respectively, in group B.