Lisinopril in the treatment of congestive heart failure

Abstract

In a series of studies, lisinopril, a new, once-daily, non-sulphydryl-containing ACE inhibitor, has been evaluated for the treatment of congestive heart failure (CHF). Lisinopril significantly improved exercise duration, left ventricular ejection fraction (LVEF) and the clinical signs and symptoms of CHF when compared with placebo in a 12-week prospective, randomised, double-blind trial involving 130 patients (NYHA Class II-IV) who were also receiving digitalis and diuretics. In another study involving 10 patients with CHF, lisinopril was found to increase maximal oxygen uptake. Lisinopril has also been compared with captopril in a 12-week randomised, double-blind, parallel trial in 189 patients with CHF (Class II-IV) on digoxin and diuretics. Both lisinopril and captopril increased treadmill exercise times. However, lisinopril was equally effective in patients with renal impairment whereas captopril was not. Also, lisinopril, but not captopril, improved LVEF. In all studies, lisinopril was well tolerated in a manner similar to captopril. Lisinopril produces more frequent increases in serum creatinine than captopril, but these changes are rarely of significant consequence. These results confirm those of previous studies, from which it is concluded that lisinopril is an important addition to the ACE inhibitor class for the treatment of CHF.