Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS I)

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Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS I) Multicenter, randomized, double-blind, placebo-controlled trial 253 patients; 126 placebo, 127 enalapril followed for an average of 188 days Patient History: Class IV CHF patients Conventional treatment for heart failure was continued in both groups CONSENSUS Study Group N Eng J Med 1987

CONSENSUS I Cumulative Probability of Death in the Placebo and Enalapril Groups 31% reduction p=0.001 40% reduction p=0.002 CONSENSUS Study Group N Eng J Med 1987

CONSENSUS I Results A significant improvement in NYHA classification was observed in the enalapril group, together with a reduction in heart size and a reduced requirement for other medications for heart failure The overall withdrawal rate was similar in both groups, but hypotension requiring withdrawal occurred in seven patients in the enalapril group an in no patients in the placebo group After the initial dose of enalapril was reduced to 2.5 mg daily in high-risk patients, this side effect was less frequent CONSENSUS Study Group N Eng J Med 1987