Author/Authors :
John B. Kostis، نويسنده , , Brent Shelton، نويسنده , , Gilbert Gosselin، نويسنده , , Claude Goulet، نويسنده , , William B. Hood Jr.، نويسنده , , Robert M. Kohn، نويسنده , , Spencer H. Kubo، نويسنده , , Eleanor Schron، نويسنده , , Melvin B. Weiss، نويسنده , , Park W. Willis III، نويسنده , , James B. Young، نويسنده , , Jeffrey Probstfield، نويسنده , , SOLVD Investigators، نويسنده ,
Abstract :
In the Studies of Left Ventricular Dysfunction (LVD), enalapril or placebo was administered in a double-blind fashion to 6797 participants with ejection fraction ≤0.35. During 40 monthsʹ average follow-up, 28.1% of participants randomized to enalapril reported side effects compared with 16.0% in the placebo group (p < 0.0001). Enalapril use was associated with a higher rate of symptoms related to hypotension (14.8% vs 7.1%, p < 0.0001), azotemia (3.8% vs 1.6%, p < 0.0001), cough (5.0% vs 2.0%, p < 0.0001), fatigue (5.8% vs 3.5%, p < 0.0001), hyperkalemia (1.2% vs 0.4%, p = 0.0002), and angioedema (0.4% vs 0.1%, p < 0.05). Side effects resulted in discontinuation of blinded therapy in 15.2% of the enalapril group compared with 8.6% in the placebo group (p < 0.0001). Thus enalapril is well tolerated by patients with LVD; however, hypotension, azotemia, cough, fatigue, and other side effects result in discontinuation of therapy in a significant minority of patients
