Open AccessCaptopril improves hemodynamic response to static exercise in patients with congestive heart failure: A double‐blind, placebo‐controlled, randomized trial
Author(s) -
Borgi C.,
Costa F. V.,
Ambrosioni E.,
Magelli C.,
Magnani B.
Publication year - 1990
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960130506
Subject(s) - captopril , medicine , isometric exercise , blood pressure , cardiology , hemodynamics , placebo , heart failure , vascular resistance , anesthesia , alternative medicine , pathology
Systemic and peripheral hemodynamic response to isometric exercise by handgrip test at 30% maximal voluntary contraction (MVC) for 3 minutes was assessed in 16 patients with congestive heart failure (CHF) after short‐term treatment with either captopril or placebo given according to a double‐blind, randomized, crossover sequence. During placebo, isometric exercise increased blood pressure (BP) and total peripheral vascular resistance (TPVR) and decreased cardiac index (CI). Captopril reduced the pressor response to exercise (mean±SD) (% systolic: from 14.7±6 to 11.7±3; p<.05/% diastolic: from 12.4±4 to 8±3; p<.005) and increased CI (from 2.3 ± .6 to 2.6± .9 liters/min/m 2 ; p<.01) whereas TPVR remained virtually unchanged (from 1479±597 to 1594±692 U; NS). The changes in mean BP after exercise were inversely related to the early increase in forearm blood flow (FBF) in exercising forearm during both placebo (r=.67) and captopril (r=.71). The extent of reduction in mean BP response after captopril was inversely related to the extra increase in exercising FBF determined by the drug when compared to placebo (r=.73). We conclude that captopril is able to improve the hemodynamic response to static exercise in patients with CHF, probably by increasing the blood supply to exercising muscles during contraction, thus blunting the extent of reflex pressor response.