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document
An open , parallel group comparison of quinapril and captopril , when added to diuretic therapy , in the treatment of elderly patients with heart failure . This study aimed to compare the efficacy , tolerability and first-dose blood-pressure response of once-daily quinapril and twice-daily captopril when added to diuretic therapy in elderly patients with heart failure . The study was performed at a single centre as an open randomised parallel-group study , patients being selected for inclusion from the outpatient population . Following a starting dose of either 2.5 mg once-daily quinapril , or 6.25 mg twice-daily captopril , patients were reviewed at two-weekly intervals , and following clinical assessment a decision was made either to titrate up to the next medication stage or to enter the patient into the 16-week maintenance phase . Efficacy was assessed using a six-minute walking test , the New York Heart Association ( NYHA ) class , a functional lifescale ( FLS ) questionnaire and the cardiothoracic ratio ( CTR ) -at study entry and at the end of the maintenance phase . Blood pressure was measured for 5 h post-first-dose of medication . Sixty-one patients were randomised to treatment : 30 to quinapril and 31 to captopril . Following withdrawals , data from 36 patients ( 20 on quinapril , 16 on captopril ) were available for analysis . The distance walked during the six-minute walking test improved in both groups ; the difference between the treatment groups was not statistically significant . There were no significant changes in the FLS or CTR . An analysis of change in the NYHA status from study entry to study end showed a statistically significant difference between the two groups ( p = 0.02 ) in favour of quinapril . Five patients in each group experienced hypotension during the 5 h following the first dose of medication . This study has shown heart failure to be as well controlled by once-daily quinapril as by twice-daily captopril , with comparable effects on first-dose blood-pressure response .
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
captopril
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Intervention_Physical
diuretic therapy
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
captopril
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Intervention_Pharmacological
diuretic therapy
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
captopril
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
captopril
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
captopril
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
captopril
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Outcome_Other
efficacy , tolerability and first-dose blood-pressure response
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Outcome_Other
Efficacy
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Outcome_Other
assessed
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Outcome_Physical
Blood pressure
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Outcome_Physical
distance walked during the six-minute walking test improved
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Outcome_Other
statistically significant .
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Outcome_Physical
FLS or CTR
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Outcome_Other
statistically significant difference
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Outcome_Physical
hypotension
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Outcome_Physical
first-dose blood-pressure response
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Participant_Condition
elderly patients with heart failure .