Short- and long-acting angiotensin-converting enzyme inhibitors: a randomized trial of lisinopril versus captopril in the treatment of congestive heart failure. The Multicenter Lisinopril-Captopril Congestive Heart Failure Study Group

Tulane University Medical Center, New Orleans, Louisiana 70112.

A randomized, parallel, double-blind study was performed with lisinopril, a long-acting angiotensin-converting enzyme inhibitor, versus captopril, a shorter-acting angiotensin-converting enzyme inhibitor, in the treatment of congestive heart failure. All patients were in New York Heart Association class II, III or IV and had remained symptomatic despite therapy with digoxin and diuretics. After a 4 to 14 day placebo baseline period, patients were randomized to receive either lisinopril, 5 mg orally once per day (n = 94), or captopril, 12.5 mg orally three times per day (n = 95), in addition to continuation of digoxin and diuretics. The dose of study drug could be doubled at 4 week intervals for a total of 12 weeks of double-blind therapy. The maximal dose was 20 mg once per day of lisinopril or 50 mg three times per day of captopril. The addition of either lisinopril or captopril to a regimen of diuretics or digoxin, or both, caused an increase in exercise duration as assessed on a motorized treadmill. When protocol violators were excluded, patients receiving lisinopril had a statistically greater increase in exercise duration than that of patients receiving captopril. In patients with renal impairment (serum creatinine greater than 1.6 mg/dl at baseline), lisinopril was superior to captopril in improving exercise duration. Lisinopril, but not captopril, increased left ventricular ejection fraction in patients with moderately to severely (less than 35%) decreased function (p less than 0.05). Improvement in functional capacity and quality of life, as assessed by the Yale Scale dyspnea/fatigue index, was significantly greater for the lisinopril group.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				L. Pilote MD PhD, M. Abrahamowicz PhD, M. Eisenberg MD MPH, K. Humphries DSc, H. Behlouli MSc PhD, and J. V. Tu MD PhD Effect of different angiotensin-converting-enzyme inhibitors on mortality among elderly patients with congestive heart failure Can. Med. Assoc. J., May 6, 2008; 178(10): 1303 - 1311. [Abstract] [Full Text] [PDF]

				J. Yoshida, K. Yamamoto, T. Mano, Y. Sakata, M. Nishio, T. Ohtani, M. Hori, T. Miwa, and T. Masuyama Different effects of long- and short-acting loop diuretics on survival rate in Dahl high-salt heart failure model rats Cardiovasc Res, October 1, 2005; 68(1): 118 - 127. [Abstract] [Full Text] [PDF]

				L. Pilote, M. Abrahamowicz, E. Rodrigues, M. J. Eisenberg, and E. Rahme Mortality Rates in Elderly Patients Who Take Different Angiotensin-Converting Enzyme Inhibitors after Acute Myocardial Infarction: A Class Effect? Ann Intern Med, July 20, 2004; 141(2): 102 - 112. [Abstract] [Full Text] [PDF]

				M. A. Munger, S. F. Gardner, and R. C. Jarvis Endocrinologic Warfare: The Role of Angiotensin-Converting Enzyme Inhibitors in Congestive Heart Failure Journal of Pharmacy Practice, January 1, 1990; 3(5): 318 - 331. [Abstract] [PDF]

				ACE INHIBITORS FOR CONGESTIVE HEART FAILURE: WHICH IS BEST? Journal Watch (General), May 16, 1989; 1989(516): 8 - 8. [Full Text]