COMPARATIVE EFFICACY OF ACE INHIBITORS (RAMIPRIL VS ENALAPRIL) IN TREATMENT OF CHRONIC HEART FAILURE IN WOMEN

Aim. To compare clinical and haemodynamic efficacy of ramipril vs enalapril in women with chronic heart failure (CHF). Material and methods. 60 women with non valvular CHF were included in the study. Patients were randomized in groups of ramipril or enalapril taken in addition to standard therapy. CHF severity, heart morphofunctional parameters, life quality, exercise tolerance, biomarkers (brain natriuretic peptide, von Willebrand factor) was estimated in patients initially and after 6 months of therapy. Results. Ramipril average daily dose was 11,4 mg, enalapril average daily dose - 34,2 mg. Dry cough was observed more rarely in patients treated with ramipril than in patients treated with enalapril. There was a trend to higher increase of exercise tolerance due to ramipril therapy in comparison with enalapril one (р=0,062). Ramipril, but not enalapril, reduced a number of patients with diastolic dysfunction (р=0,049). Life quality improvement was higher in ramipril treated patients in comparison with those treated with enalapril (р=0,04). Brain natriuretic peptide and von Willebrand factor levels decreased more significantly in ramipril therapy than in enalapril one (р=0,05 and р<0,05 , respectively). Conclusion. Ramipril therapy of CHF in women has higher clinical efficacy and better tolerability in comparison with enalapril therapy.