Comparison of the first dose response of Fosinopril and Captopril in congestive heart failure: a randomized, double-blind, placebo controlled study

Abstract

The purpose of this study was to compare the safety and tolerability of recommended initial doses of a long-acting angiotensin converting enzyme inhibitor (ACE-I)Fosinopril (FOS) with those of a short-acting ACE-I Captopril (CAP) in diuretic-treated, salt deplete"high risk"patients with CHF. 30 patients were randomized in a double blind fashion to recieve a single dose of either FOS 10 mg or CAP 6.25 mg or placebo.Maximal fall in MAP after theraphy within 24 h was respectively -31%,-22%,-20% (FOS-CAP, p<0.05; FOS - plasebo, p=n.s), The practical importance of the results are: Oral ACE-inhibitors have different effects on the BP after the first dose, this effect does not dependent on the plasma ACE-A level,though FOS produced ACE-I similar to CAP and BP changes similar to placebo, so it is safer in the treatment of CHF.