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Use of captopril in paediatric congestive cardiac failure: early effects on blood pressure and renal function
  1. EA Orchard,
  2. A Apps,
  3. N Wilson
  1. Department of Paediatric Cardiology, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr EA Orchard, Department of Paediatric Cardiology, John Radcliffe Hospital, 38 Chalfont Roadm, Oxford OX3 9DU, UK; elizabethorchard{at}hotmail.com

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To examine the incidence and severity of side effects on initiation of the angiotensin-converting enzyme inhibitor (ACEI) captopril in paediatric patients with congestive cardiac failure.

66 consecutive patients with congestive cardiac failure were given captopril at a mean dose of 0.1 mg/kg. Pre- and postcaptopril blood pressures were monitored every 15 min for 90 min and the largest drop in blood pressure was recorded; hypotension was defined as a >25% drop in systolic blood pressure and any symptoms noted. Plasma creatinine, urea and potassium were measured before and within a week of captopril initiation.

10 patients developed asymptomatic hypotension, two of whom had captopril stopped. There was no significant difference in the pre- and postcaptopril measurements of urea, creatinine and potassium (p=0.7, p=0.66 and p=0.97, respectively).

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