A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients

Several large placebo-controlled trials have confirmed that angiotensin converting enzyme (ACE) inhibitors significantly reduce mortality aid morbidity in all functional grades of congestive heart failure (CHF), nevertheless only a proportion of patients who may benefit from treatment are priscribe...

Full description

Bibliographic Details
Main Authors: Lukman H. Makmun, Nurhay Abdurachman, Idrus Alwi, Dedi Afandi, Bambang B. Siswanto, Hananto Andriantoro, Endang Ratnaningsih, Hari Utomo
Format: Article
Language:English
Published: Faculty of Medicine Universitas Indonesia 2002-02-01
Series:Medical Journal of Indonesia
Online Access:http://mji.ui.ac.id/journal/index.php/mji/article/view/45
id doaj-bedf3cd1b81247c0b5d8cc692466b1cb
record_format Article
spelling doaj-bedf3cd1b81247c0b5d8cc692466b1cb2020-11-25T02:39:24ZengFaculty of Medicine Universitas Indonesia Medical Journal of Indonesia0853-17732252-80832002-02-0111110.13181/mji.v11i1.4545A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patientsLukman H. MakmunNurhay AbdurachmanIdrus AlwiDedi AfandiBambang B. SiswantoHananto AndriantoroEndang RatnaningsihHari Utomo Several large placebo-controlled trials have confirmed that angiotensin converting enzyme (ACE) inhibitors significantly reduce mortality aid morbidity in all functional grades of congestive heart failure (CHF), nevertheless only a proportion of patients who may benefit from treatment are priscribed an ACE inhibitor. One of the perceived difficulties is the occurrence of first-dose hypotension in susceptible patients. A double-blind, randomised, single-dose therapy, parallel-group study was conducted with the aim to compare the first-dose responses to low dose ACE inhibitors captopril and perindopril in patients with stable chronic heart failure. Seventy patients (New York Heart Association class I-IV) were included. Blood pressure was recorded every 15 minutes 2 hours before starting treatment. The mean of these readings was taken as the baseline blood pressure. Patients were randomised to receive a single-dose of captopril 6.25 mg or perindopril 2 mg. After taking the drug, blood pressure was monitored every 15 minutes for 2 hours, every 30 minutes during 5 hours then hourly after 2 hours. The maximum mean arterial pressure fall from baseline of perindopril was 0.85 mmHg compared to captopril 4.60 mmHg. The maximum mean systolic fall from baseline of perindopril was 3 '31 'mmHg compared to captopril 6.76 mmHg while the maximum mean diastolic fall from baseline of perindopril was 1.08 mmHg compared to captopril 2.63 mmHg. The hypotensive effect of the captopril group started soon after dosing and reached its maximum after 1 to 2 hours while perindopril showed slight reduction of systolic after 1 hour and slight reduction of diastolic after 4 hours. Compared to captopril, perindopril seemed to be less likely to cause first-dose hypotension in patients with heart failure. (Med J Indones 2002; 11: 19-23) Keywords: first dose hypotension, perindopril, captopril, chronic heart failure http://mji.ui.ac.id/journal/index.php/mji/article/view/45
collection DOAJ
language English
format Article
sources DOAJ
author Lukman H. Makmun
Nurhay Abdurachman
Idrus Alwi
Dedi Afandi
Bambang B. Siswanto
Hananto Andriantoro
Endang Ratnaningsih
Hari Utomo
spellingShingle Lukman H. Makmun
Nurhay Abdurachman
Idrus Alwi
Dedi Afandi
Bambang B. Siswanto
Hananto Andriantoro
Endang Ratnaningsih
Hari Utomo
A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients
Medical Journal of Indonesia
author_facet Lukman H. Makmun
Nurhay Abdurachman
Idrus Alwi
Dedi Afandi
Bambang B. Siswanto
Hananto Andriantoro
Endang Ratnaningsih
Hari Utomo
author_sort Lukman H. Makmun
title A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients
title_short A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients
title_full A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients
title_fullStr A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients
title_full_unstemmed A randomized comparative trial of first-dose response to Angiotensin- Converting Enzyme Perindopril and Captopril in Indonesian heart failure patients
title_sort randomized comparative trial of first-dose response to angiotensin- converting enzyme perindopril and captopril in indonesian heart failure patients
publisher Faculty of Medicine Universitas Indonesia
series Medical Journal of Indonesia
issn 0853-1773
2252-8083
publishDate 2002-02-01
description Several large placebo-controlled trials have confirmed that angiotensin converting enzyme (ACE) inhibitors significantly reduce mortality aid morbidity in all functional grades of congestive heart failure (CHF), nevertheless only a proportion of patients who may benefit from treatment are priscribed an ACE inhibitor. One of the perceived difficulties is the occurrence of first-dose hypotension in susceptible patients. A double-blind, randomised, single-dose therapy, parallel-group study was conducted with the aim to compare the first-dose responses to low dose ACE inhibitors captopril and perindopril in patients with stable chronic heart failure. Seventy patients (New York Heart Association class I-IV) were included. Blood pressure was recorded every 15 minutes 2 hours before starting treatment. The mean of these readings was taken as the baseline blood pressure. Patients were randomised to receive a single-dose of captopril 6.25 mg or perindopril 2 mg. After taking the drug, blood pressure was monitored every 15 minutes for 2 hours, every 30 minutes during 5 hours then hourly after 2 hours. The maximum mean arterial pressure fall from baseline of perindopril was 0.85 mmHg compared to captopril 4.60 mmHg. The maximum mean systolic fall from baseline of perindopril was 3 '31 'mmHg compared to captopril 6.76 mmHg while the maximum mean diastolic fall from baseline of perindopril was 1.08 mmHg compared to captopril 2.63 mmHg. The hypotensive effect of the captopril group started soon after dosing and reached its maximum after 1 to 2 hours while perindopril showed slight reduction of systolic after 1 hour and slight reduction of diastolic after 4 hours. Compared to captopril, perindopril seemed to be less likely to cause first-dose hypotension in patients with heart failure. (Med J Indones 2002; 11: 19-23) Keywords: first dose hypotension, perindopril, captopril, chronic heart failure
url http://mji.ui.ac.id/journal/index.php/mji/article/view/45
work_keys_str_mv AT lukmanhmakmun arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT nurhayabdurachman arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT idrusalwi arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT dediafandi arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT bambangbsiswanto arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT hanantoandriantoro arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT endangratnaningsih arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT hariutomo arandomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT lukmanhmakmun randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT nurhayabdurachman randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT idrusalwi randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT dediafandi randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT bambangbsiswanto randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT hanantoandriantoro randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT endangratnaningsih randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
AT hariutomo randomizedcomparativetrialoffirstdoseresponsetoangiotensinconvertingenzymeperindoprilandcaptoprilinindonesianheartfailurepatients
_version_ 1724786328378277888