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Abstract
Studies of Left Ventricular Dysfunction (SOLVD) is a randomized trial of enalapril
versus placebo in reducing mortality in patients with cardiac dysfunction (defined
as left ventricular ejection fraction ≤35%). Before randomization, patients at risk
for hypotension were hospitalized for a test dose of 2.5 mg of enalapril administered
orally at baseline and again 12 hours later. As of February 1989, 89 of 7,539 (1.2%)
patients had been studied during hospitalization. Baseline systolic and diastolic
blood pressures were 115 ± 18 and 73 ± 10 mm Hg, respectively. After enalapril, systolic
blood pressure decreased slightly but significantly 8 to 20 hours after the initial
dose (mean reduction 8 to 11 mm Hg). In this highly selected group of 89 patients,
symptoms relating to decrease in blood pressure were noted in 13 (15%). It is emphasized
that most patients with cardiac dysfunction readily tolerate enalapril. However, the
agent should be administered with caution to patients with advanced congestive failure
and diminished baseline blood pressure, owing to a significant incidence of symptomatic
hypotension.
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Article info
Publication history
Accepted:
July 31,
1991
Received:
April 8,
1991
Footnotes
☆This study was supported by a contract from the National Heart, Lung and Blood Institute, Bethesda, Maryland.
Identification
Copyright
© 1991 Published by Elsevier Inc.
