Document Detail


Comparison of effects on peak oxygen consumption, quality of life, and neurohormones of felodipine and enalapril in patients with congestive heart failure.
MedLine Citation:
PMID:  7503006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Angiotensin-converting enzyme (ACE) inhibition is currently the cornerstone of congestive heart failure (CHF) therapy, but these drugs are not tolerated in up to 20% of patients. For these patients, therapeutic alternatives with comparable efficacy are needed. Felodipine, a vasoselective dihydropyridine calcium antagonist with a slow onset of action and a long plasma half-life, may be such an agent. Therefore, the efficacy and safety of felodipine were examined and compared with enalapril using a double-blind design. We studied 46 patients with a left ventricular ejection fraction < 0.40, peak oxygen consumption < 20 ml.min-1.kg-1, and symptoms of CHF despite therapy with diuretics and digoxin. After 16 weeks of therapy, there were no statistically significant differences in peak oxygen consumption (felodipine +1.6, enalapril +2.5 ml.min-1.kg-1) and exercise tolerance (felodipine +61 seconds, enalapril +64 seconds). Quality-of-life parameters were affected slightly better by felodipine than by enalapril. Plasma norepinephrine decreased by 143 pg.ml-1 with enalapril and by 12 pg.ml-1 with felodipine (p < 0.20 between groups). Both drugs were generally well tolerated. These data suggest that felodipine and enalapril have comparable effects on exercise parameters in patients with CHF. Neurohumoral activation was not observed with either drug.
Authors:
R J de Vries; M Queré; D J Lok; P Sijbring; J J Bucx; D J van Veldhuisen; P H Dunselman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  76     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-01-18     Completed Date:  1996-01-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1253-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Ignatius Hospital, Breda, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  therapeutic use*
Calcium Channel Blockers / adverse effects,  pharmacology,  therapeutic use*
Double-Blind Method
Enalapril / adverse effects,  therapeutic use*
Exercise Tolerance / drug effects
Felodipine / adverse effects,  pharmacology,  therapeutic use*
Female
Heart Failure / blood,  drug therapy*,  physiopathology
Humans
Male
Middle Aged
Norepinephrine / blood
Oxygen Consumption / drug effects
Quality of Life
Renin / blood
Vasodilator Agents / adverse effects,  pharmacology,  therapeutic use*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Calcium Channel Blockers; 0/Vasodilator Agents; 51-41-2/Norepinephrine; 52-39-1/Aldosterone; 72509-76-3/Felodipine; 75847-73-3/Enalapril; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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