INITIAL BLOOD-PRESSURE RESPONSE TO ENALAPRIL IN HOSPITALIZED-PATIENTS (STUDIES OF LEFT-VENTRICULAR DYSFUNCTION [SOLVD])

被引:12
作者
HOOD, WB
YOUNGBLOOD, M
GHALI, JK
REID, M
ROGERS, WJ
HOWE, D
TEO, KK
LEJEMTEL, TH
机构
[1] University of Rochester Medical Center, Rochester, NY
关键词
D O I
10.1016/0002-9149(91)90280-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Studies of Left Ventricular Dysfunction (SOLVD) is a randomized trial of enalapril versus placebo in reducing mortality in patients with cardiac dysfunction (defined as left ventricular ejection fraction less-than-or-equal-to 35%). Before randomization, patients at risk for hypotension were hospitalized for a test dose of 2.5 mg of enalapril administered orally at baseline and again 12 hours later. As of February 1989, 89 of 7,539 (1.2%) patients had been studied during hospitalization. Baseline systolic and diastolic blood pressures were 115 +/- 18 and 73 +/- 10 mm Hg, respectively. After enalapril, systolic blood pressure decreased slightly but significantly 8 to 20 hours after the initial dose (mean reduction 8 to 11 mm Hg). In this highly selected group of 89 patients, symptoms relating to decrease in blood pressure were noted in 13 (15%). It is emphasized that most patients with cardiac dysfunction readily tolerate enalapril. However, the agent should be administered with caution to patients with advanced congestive failure and diminished baseline blood pressure, owing to a significant incidence of symptomatic hypotension.
引用
收藏
页码:1465 / 1468
页数:4
相关论文
共 19 条
[1]   IMMEDIATE AND SUSTAINED HEMODYNAMIC AND CLINICAL IMPROVEMENT IN CHRONIC HEART-FAILURE BY AN ORAL ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR [J].
ADER, R ;
CHATTERJEE, K ;
PORTS, T ;
BRUNDAGE, B ;
HIRAMATSU, B ;
PARMLEY, W .
CIRCULATION, 1980, 61 (05) :931-937
[2]   SEVERE HYPOTENSION AFTER 1ST DOSE OF ENALAPRIL IN HEART-FAILURE [J].
CLELAND, JGF ;
DARGIE, HJ ;
MCALPINE, H ;
BALL, SG ;
MORTON, JJ ;
ROBERTSON, JIS ;
FORD, I .
BRITISH MEDICAL JOURNAL, 1985, 291 (6505) :1309-1312
[3]  
COHN JN, 1983, J AM COLL CARDIOL, V2, P755
[4]   ACUTE AND LONG-TERM EFFECTS OF ENALAPRIL ON THE CARDIOVASCULAR-RESPONSE TO EXERCISE AND EXERCISE TOLERANCE IN PATIENTS WITH CONGESTIVE HEART-FAILURE [J].
CREAGER, MA ;
MASSIE, BM ;
FAXON, DP ;
FRIEDMAN, SD ;
KRAMER, BL ;
WEINER, DA ;
RYAN, TJ ;
TOPIC, N ;
MELIDOSSIAN, CD .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1985, 6 (01) :163-170
[5]   A COMPARISON OF HYPOTENSIVE RESPONSES AFTER ORAL AND INTRAVENOUS ADMINISTRATION OF ENALAPRIL AND LISINOPRIL IN CHRONIC HEART-FAILURE [J].
DICKSTEIN, K ;
AARSLAND, T ;
TJELTA, K ;
CIRILLO, VJ ;
GOMEZ, HJ .
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 1987, 9 (06) :705-710
[6]  
DZAU VJ, 1981, CIRCULATION, V63, P645, DOI 10.1161/01.CIR.63.3.645
[7]   SUSTAINED EFFECTIVENESS OF CONVERTING-ENZYME INHIBITION IN PATIENTS WITH SEVERE CONGESTIVE HEART-FAILURE [J].
DZAU, VJ ;
COLUCCI, WS ;
WILLIAMS, GH ;
CURFMAN, G ;
MEGGS, L ;
HOLLENBERG, NK .
NEW ENGLAND JOURNAL OF MEDICINE, 1980, 302 (25) :1373-1379
[8]   CAPTOPRIL - 4 YEARS OF POST MARKETING SURVEILLANCE OF ALL PATIENTS IN NEW-ZEALAND [J].
EDWARDS, IR ;
COULTER, DM ;
BEASLEY, DMG ;
MACINTOSH, D .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 1987, 23 (05) :529-536
[9]   CENTRAL AND PERIPHERAL HEMODYNAMIC-EFFECTS OF ANGIOTENSIN INHIBITION IN PATIENTS WITH REFRACTORY CONGESTIVE HEART-FAILURE [J].
FAXON, DP ;
CREAGER, MA ;
HALPERIN, JL ;
GAVRAS, H ;
COFFMAN, JD ;
RYAN, TJ .
CIRCULATION, 1980, 61 (05) :925-930
[10]  
GOLDSTEIN S, 1988, JAMA-J AM MED ASSOC, V259, P539