1. 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

2. 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

3. 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