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A Randomized Double-blind Placebo-controlled Trial to Increase Feasibility of Dobutamine Stress Echocardiography in Patients with Hypertension.

Author(s): Rodrigues AC, Hotta VT, Maciel de Oliveira Borges Neto F, Theotonio Dos Santos JM, Hannouche Trindade ML, Mathias W Jr

Affiliation(s): Heart Institute (InCor) - HC - Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.

Publication date & source: 2007-09-27, J Am Soc Echocardiogr., [Epub ahead of print]

OBJECTIVE: To increase dobutamine stress echocardiography feasibility in patients with uncontrolled hypertension, we studied 729 consecutive patients referred for ischemia assessment. METHODS: Patients with blood pressure (BP) levels above 160/110 mm Hg were randomized to sublingual placebo or captopril (25 mg), and dobutamine stress echocardiography undertaken if BP decreased below 160/110 mm Hg after 15 minutes. RESULTS: Of 149 patients (20%) with high BP levels, 104 (63 +/- 11 years, 51 male) were randomized. Baseline BP levels were similar for captopril (178 +/- 15/103 +/- 15 mm Hg) and placebo (181 +/-17/103 +/- 15 mm Hg) groups. After intervention, 15 patients from captopril and 17 from placebo group had decreased BP (11% and 12% for systolic and 13% and 13% for diastolic BP, respectively). Five patients from placebo group (P = .007) had to prematurely terminate the test because of hypertension (BP > 220/120 mm Hg). Feasibility was similar for captopril and placebo groups (35% vs 25%, respectively, P = not significant). CONCLUSION: Although both captopril and placebo are effective in increasing dobutamine stress echocardiography feasibility in patients with uncontrolled BP, test interruption because of hypertension is less likely to occur after captopril administration.

Page last updated: 2007-10-18

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