Enalapril in the treatment of mild-to-moderate heart failure in general medical practice: a prospective and multicentre study concerning 17,546 patients.

The objective of this study was to test the efficacy and tolerability of a precise dosage regimen of enalapril in general medical practice, in combination with conventional therapy, in patients with mild-to-moderate (NYHA classes II and III) congestive heart failure (CHF). 17,546 patients were prospectively included in this multicentre study. After three months of treatment with enalapril, 53.9% of patients were asymptomatic (NYHA Class I) and 75.1% of patients improved by at least one class in the NYHA classification. 64.6% of patients reached maintenance dosage of 20 mg/day of enalapril and mean daily dosage for all patients was 16 mg. Outcome of functional symptoms according to NYHA class was more favourable with maintenance dosages of 15 and 20 mg/day of enalapril than with maintenance dosages of 5 and 10 mg/day of enalapril. Clinical and laboratory safety was good with low rates observed of the main adverse events: cough (1.74%), hypotension (0.34%), postular hypotension (0.30%), dizziness (0.31%) and hyperkaliema (0.13%); 1.4% of patients dropped out of the study because of such events. This extensive and open study confirms, in general medical practice, the feasibility, efficacy and tolerability of a dosage regimen of enalapril, which has been previously determined in controlled studies performed in specialized medical centres, for treatment of mild-to-moderate heart failure.