Lege Artis Medicinae

[Vasocilator - Heart Failure Trial 2.]

MATOS Lajos1

JANUARY 27, 1993

Lege Artis Medicinae - 1993;3(01)

[After two years, mortality was significantly lower among those treated with enalapril (18%) than in the hydralazine + nitrate group (28%; p<0.016). The beneficial effect of enalapril therapy was due to a reduction in the incidence of sudden cardiac death and was predominantly in less severe patients (NYHA I-II). The reduction in blood pressure during the first 13 weeks was significantly more pronounced in the enalapril group. Ejection fraction increased significantly with both treatment regimens, but the increase was greater after week 13 in the hydralazine + nitrate group. Oxygen consumption at peak exercise was higher only in those treated with the hydralazine + isosorbide dinitrate combination. As a side effect, hydralazine + isosorbide dinitrate treatment was associated more frequently with headache, while enalapril therapy caused hypotension and cough more frequently. ]

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[Vasocilator - Heart Failure Trial 1.]

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[After one year, the mortality rate was 12.1% in the hydralazine + isosorbide dinitrate group and 19.5% in the placebo group, representing a 38% reduction in mortality in those receiving active treatment, and 25.6% (hydralazine + nitrate) and 34.3% (placebo) after two years, and 36.2% (hydralazine + nitrate) and 46.9% (placebo) after three years. Over the entire follow-up period, there were 91 deaths in the prazosin-treated group (49.7%), 72 (38.7%) in the hydralazine + isosorbide dinitrate-treated group and 120 (44%) in the placebo group. In the hydralazine + nitrate group, left ventricular ejection fraction increased significantly at week 8 and at 1-year follow-up, but did not change between patients treated with prazosin or placebo.]

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