Short and long-term effects of treatment with low dose captopril in patients with severe congestive heart failure.

1 In an open study the clinical short-term and long-term effects of low-dose captopril (mean daily dose 45 +/- 15 mg) were evaluated in 20 patients with severe congestive heart failure refractory to conventional treatment with digitalis and diuretics. 2 After two weeks' treatment 16 out of 20 patients showed an improvement in New York Heart Association functional class, followed by a significant reduction in body weight and heart volume. The ratio between urinary sodium and potassium excretion was significantly increased and the urinary aldosterone excretion was significantly decrease. In 10 of the patients the initial effects were sustained during long-term treatment (6 +/- 2 months). 3 In conclusion, captopril may be a useful therapeutic adjunct for the long-term treatment of patients with severe heart failure or when conventional treatment has failed.