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A multicenter study of the safety and efficacy of benazepril hydrochloride, a long‐acting angiotensin‐converting enzyme inhibitor, in patients with chronic congestive heart failure
Author(s) -
Insel Jerald,
Mirvis David M,
Boland Michael J,
Cinquegrani Michael P,
Shanes Jeffrey,
Rubin Stanley A,
Whalen John J
Publication year - 1989
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1989.34
Subject(s) - benazepril , heart failure , medicine , pulmonary wedge pressure , angiotensin converting enzyme , pulmonary artery , vascular resistance , cardiology , cardiac output , aldosterone , pulmonary hypertension , blood pressure , hemodynamics
Benazepril hydrochloride is a nonsulfhydryl, long‐acting angiotensin‐converting enzyme inhibitor that is orally effective. This study was designed to determine the acute hemodynamic effects of this agent in patients with chronic congestive heart failure. Twenty‐six patients with New York Heart Association class III or IV congestive heart failure and left ventricular ejection fractions <35%, cardiac indexes <2.1 L/min/m 2 , and pulmonary artery wedge pressures >12 mm Hg were given 2 or 5 mg benazepril hydrochloride. All doses produced significant ( p < 0.05) increases in cardiac output (26.7% to 31.6% above control) and heart rate (5.4% to 11.2% above control) and decreases in systemic (27.1% to 32.0% below control) and pulmonary (34.8% to 55.5% below control) vascular resistances, mean pulmonary (25.3% to 30.3% below control) and systemic (13.4% to 18.5% below control) arterial pressures, and pulmonary artery wedge pressure (46.9% to 51.1% below control). Twenty‐four hours after an initial dose, systemic vascular resistance and pulmonary artery wedge pressures remained below control levels. Angiotensin‐converting enzyme activity fell by 67.8% ± 6.4%, with a 15.8% ± 7.6% decline in aldosterone levels. Thus benazepril hydrochloride is an effective angiotensin‐converting enzyme inhibitor that produces hemodynamic effects that persist for 24 hours after a single oral dose. Clinical Pharmacology and Therapeutics (1989) 45, 312–320; doi: 10.1038/clpt.1989.34