[Effectiveness of Lisinopril in the treatment of heart failure]. / Lisinopril-kezelés hatékonyságának vizsgálata kardiális dekompenzációban szenvedó betegeken.

A prospective study was performed in patients (30 M, 16 F, mean age of 56.0 +/- 9.2 [42-73] years) with congestive heart failure to assess the efficacy of lisinopril during a 16 weeks treatment period. Changes in clinical signs, functional capacity, blood pressure, heart rate, echocardiographic parameters, exercise duration, laboratory data and quality of life were measured. After a 2-week run-in period starting daily dose of study drug was 5 mg, and an increase of medication was considered at 4 weeks. At the end of the study mean daily dose of lisinopril was 15.1 +/- 6.2 mg. Improvement of NYHA status by 2 grades was observed in 4 cases (9%), by 1 grade in 24 cases (51%), there was no change in 17 cases (38%), and worsening was observed in 1 case (2%). During the study both systolic (p = 0.001) and diastolic blood pressure (p = 0.0006) decreased significantly, the changes in pulse rate were not significant. Left ventricular end systolic (p = 0.001) and end diastolic (p = 0.003) dimensions decreased, ejection fraction rose by 4.4% (p = 0.0002). One patient was removed from the study because of drug-induced cough. Comparison of all the laboratory data for pre and post-study periods did not reveal any significant difference. Patients treated with lisinopril improved significantly for clinical, haemodynamic, echocardiographic and quality of life parameters, with few adverse experiences, good tolerability and once-daily dose.

[Evaluation of captopril-enalapril replacement therapy in hypertensive patients under ambulatory blood pressure monitoring]. / Captopril-enalapril terápiás átállítás viszgálata hypertoniás betegeken ambuláns vérnyomás-monitorozás mellett.

Authors performed a comparative study of replacement of captopril (2-3x daily) therapy with once daily enalapril. Blood pressure was measured by 24-hour ambulatory monitoring. The study enrolled 62 patients with mild to moderate hypertension. Captopril was previously administered 2-4 times per day, in mean dose of 74.4 mg, for 3.2 years as an average. After a 4 x 4 weeks study period the final enalapril dose was 15 mg, once in the morning. Enalapril was administered as monotherapy in 36 cases. During the trial mean blood pressure decreased from 140 +/- 14/85 +/- 9 mmHg to 125 +/- 12/76 +/- 7 mmHg (p < 0.01), diurnal index increased from 12/10% to 15/11%. Enalapril treatment lowered daytime percent time elevation index (PTI) from 56 +/- 30% to 27 +/- 23% (p < 0.05), nighttime PTI from 64 +/- 34% to 37 +/- 35% (p < 0.05), and hyperbaric impact values from 183 +/- 152 mmHg x hour to 97 +/- 128 mmHg x hour (p < 0.01). Adverse effects of both drugs were rare and mild, enalapril caused no changes in overall quality of life. Improvement of antihypertensive efficacy after a switch to enalapril treatment could be related to better compliance achieved by once-daily dose, and tight out-patient blood pressure control. The authors concluded that after a 16 weeks of therapy, once-daily enalapril administration was more effective and compliant in reducing blood pressure, than 2-4 times per day captopril treatment, when measured by 24-hour ambulatory blood pressure monitoring.