Lisinopril versus placebo in older congestive heart failure patients

This article reports the results of a multicenter international study of the use of lisinopril in patients with congestive heart failure also receiving digoxin, diuretics, or both. Two thirds of the 130 subjects enrolled in the study received lisinopril and one third received placebo. Lisinopril treatment led to a significant improvement in both bicycle and treadmill exercise tolerance, New York Heart Association classification status, cardiac function assessed noninvasively, and symptomatology. There was no age differentiation; the same improvement was achieved in the 35 patients over 65 years old as in the younger patients. There was a mild decrease in both systolic and diastolic blood pressure in patients receiving lisinopril, peaking at seven hours. These changes, however, were not significantly different from those seen with placebo. Apart from one patient in whom hypotension developed followed by reversible renal failure, there were no serious adverse effects, and the incidence of sudden death and biochemical abnormalities was no different from that seen with placebo. This study confirms that this agent is an effective, safe, well-tolerated agent in the treatment of congestive cardiac failure and is equally applicable to younger and older patients.