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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).